Table of Content

30 September 2026, Volume 13 Issue 3

Previous Issue   

Guidelines and Consensus

Chinese expert consensus on dual immune checkpoint inhibitor therapy for hepatocellular carcinoma

China International Exchange Association for Medical and Health Care, Liver Tumor Oncology Branch, China International Exchange Association for Medical and Health Care, Tumor Immunotherapy Branch

2026, 13(3):  1-12. 

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Chinese expert consensus on adverse reaction management for dual immunotherapy in hepatocellular carcinoma

The Liver Oncology Branch of the China Association for the Promotion of International Exchange in Healthcare, the Immunology Branch of the China Association for the Promotion of International Exchange in Healthcare, the Digestive Tumor Comprehensive Diagnosis and Treatment Branch of the China Association for the Promotion of International Exchange in Healthcare, et al

2026, 13(3):  13-28. 

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Special topic

The surgical treatment of colorectal liver metastases

Liu Wei, Xing Baocai

2026, 13(3):  29-33. 

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According to the National Cancer Report by the National Cancer Center of China, as of 2022, the incidence ranking of colorectal cancer has risen from 4th to 2nd, and its mortality ranking has increased from 5th to 4th, making it a disease that currently poses a severe threat to public health and survival. The factor most closely associated with the poor prognosis and mortality of colorectal cancer is colorectal liver metastasis (CRLM). Data accumulated over the past three decades have demonstrated that patients with CRLM treated with systemic therapy combined with surgical resection can achieve a 5 year survival rate of 40%-50%, and some patients can be cured. Resection of liver metastases plays a crucial role in achieving such favorable long term survival. With the rising incidence of colorectal cancer, the number of patients with liver metastasis continues to increase annually. The authors believe that hepatic surgeons should actively participate in the multidisciplinary diagnosis and treatment of liver metastases, and provide standardized and individualized local treatment for patients with CRLM based on specific clinical conditions.
To select appropriate local surgical therapies and develop rational treatment strategies for individual patients, hepatic surgeons must continuously improve their professional knowledge and update treatment concepts.

Advances in the application of stereotactic body radiotherapy for colorectal cancer liver metastases

Wang Hongzhi, Dong Dezuo, Zheng Xuan, Wang Weihu

2026, 13(3):  34-39. 

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Stereotactic body radiotherapy(SBRT) serves as a vital local therapeutic modality for colorectal cancer liver metastases (CRLM). Among local therapeutic modalities, it highlights the significance of complementary advantages among surgical resection, thermal ablation and SBRT. This article reviews the efficacy and adverse events of high-quality SBRT reported in recent years, discusses the major factors governing the therapeutic outcomes of SBRT for liver metastases, and underscores the critical role of liver motion management and image-guided techniques in local tumor control. It also elaborates on the advances of proton and heavy-ion radiotherapy in the management of CRLM.

Advances in hepatic arterial infusion chemotherapy for colorectal liver metastases

Fan Xiaoyu, Zheng Kanglian, Wang Xiaodong

2026, 13(3):  40-50. 

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Approximately 50% of patients with colorectal cancer (CRC) develop liver metastases during the course of their disease. Liver metastases have become a key determinant of long-term prognosis in patients with CRC, and multiple studies have demonstrated the poor prognosis of patients with colorectal cancer liver metastases (CRLM). In recent years, hepatic arterial infusion chemotherapy (HAIC) has been recommended by multiple Chinese and international guidelines in treating CRLM. In addition, several prospective phase Ⅱ/Ⅲ clinical trials and retrospective studies with large sample size have demonstrated the efficacy and safety of HAIC, either alone or in combination with systemic therapy, for patients with CRLM. Based on the available literature and clinical experience, this review summarizes recent advances in HAIC for CRLM, including technical essentials, drug selection, and its clinical value as adjuvant therapy for resectable liver metastases, conversion therapy for initially unresectable liver metastases, first-line therapy for advanced unresectable liver metastases, and salvage therapy. This review aims to provide a practical reference for the clinical application of HAIC in treating CRLM.

Advances in ablation therapy for colorectal liver metastases

Jiang Binbin, Wu Jingyu, Wu Wei

2026, 13(3):  51-58. 

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Colorectal liver metastases (CRLM) are a major cause of death in patients with colorectal cancer. Approximately 30%-50% of patients develop liver metastases during the disease course, and only about 20% are candidates for surgical resection. Image-guided ablation is minimally invasive and repeatable and has become an important component of the multidisciplinary management of CRLM. This review summarizes the clinical applications of ablation, factors influencing efficacy, comparisons with surgical resection, and its role in multimodal treatment, and discusses future directions. Current evidence suggests that, in carefully selected patients with oligometastatic liver disease, particularly those with lesions ≤3 cm, thermal ablation is non-inferior to surgical resection in terms of overall survival and is associated with a lower incidence of adverse events. In selected patients with unresectable, liver-limited disease and a limited number of metastases, adding aggressive local treatment, including ablation, to systemic therapy may improve long-term survival. Advances in image navigation and artificial intelligence may further expand and refine the role of ablation in CRLM management.

Original article

Analysis of risk factors for severe abdominal pain induced by FOLFOX-HAIC treatment in hepatic malignancies

Yue Zipeng, Zhang Wei, Wang Liang, Tang Yongsheng, Zi Yang, Shi Baoqi

2026, 13(3):  59-65. 

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Objective:This study aims to analyze the risk factors for severe abdominal pain in patients with liver malignant tumors treated with FOLFOX regimen hepatic arterial infusion chemotherapy (HAIC) in order to optimize the treatment plan and improve treatment tolerance.
Methods:This study retrospectively analyzed the data of 217 patients with primary and secondary liver malignancy who received FOLFOX-HAIC treatment at the Department of Imaging Medicine, Inner Mongolia People's Hospital, from January 2021 to December 2024. A total of 33 patients who experienced abdominal pain during HAIC pump medication and within 24 hours after medication cessation were analyzed. These patients were categorized into a severe abdominal pain group and a mild abdominal pain group based on visual analog scale (VAS) scores. Univariate and multivariate Logistic regression analyses were conducted to identify factors contributing to severe abdominal pain. Additionally, a Kendall correlation analysis was performed to examine the relationship between VAS scores in the severe pain group and the diameter of the catheterized artery.
Results:Of these 33 patients, 16 experienced severe abdominal pain （VAS≥7), and 17 experienced mild-to-moderate abdominal pain (VAS < 7). Baseline characteristics were comparable between the two groups, with no statistically significant differences (all P>0.05), except for the total dose of oxaliplatin and the diameters of the common hepatic artery, proper hepatic artery, and catheterized artery. Univariate logistic analysis identified age, diameters of the common hepatic artery, proper hepatic artery, and catheterized artery, as well as the total dose of oxaliplatin, as factors associated with severe abdominal pain (all P<0.05). Multivariate logistic analysis revealed that the diameter of the catheterized artery was an independent risk factor for severe abdominal pain (P<0.05). Further analysis of the correlation between VAS scores and catheterized artery diameter in the severe abdominal pain group demonstrated a significant negative correlation (r= -0.535, P<0.05).
Conclusions:This study shows that the diameter of the catheterized artery is an independent risk factor for the occurrence of severe abdominal pain after FOLFOX-HAIC treatment. Smaller artery diameter may lead to local ischemia, thereby causing severe abdominal pain.

Effects of an operating room waiting management program based on just-in-time adaptive intervention theory on patients undergoing laparoscopic hepatectomy

Shao Jingyi, Ai Xiaoming, Tang Weiding

2026, 13(3):  66-72. 

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Objective:To evaluate the effects of an operating room waiting management program based on the just-in-time adaptive intervention (JITAI) theory on the preoperative waiting experience in patients undergoing laparoscopic hepatectomy.
Methods:Using convenience sampling method, a total of 70 patients who underwent laparoscopic hepatectomy at Affiliated Hospital of Jiangsu University between November 2022 and June 2026 were enrolled and divided into two groups according to admission time: a control group (between November 2022 and December 2024, n=35) and an observation group (between January 2025 and June 2026, n=35). The control group received routine operating room waiting management procedures, while the observation group received the JITAI-based operating room waiting management program in addition to routine care. The two groups were compared in terms of actual waiting time and perceived waiting time. Mean arterial pressure (MAP) and heart rate (HR) were measured. Anxiety levels were assessed using the self-rating anxiety scale (SAS), and patient satisfaction was evaluated using a self-designed satisfaction questionnaire.
Results:The observation group had significantly shorter actual waiting time and perceived waiting time than the control group (both P<0.05). SAS scores, as well as MAP and HR measured at the time of leaving the operating room waiting area, were significantly lower in the observation group than in the control group (all P<0.05). Patient satisfaction scores were significantly higher in the observation group than in the control group (P<0.05).
Conclusions:The JITAI-based operating room waiting management program can effectively shorten both actual and perceived waiting time, reduce preoperative anxiety levels, improve physiological stress responses, and enhance patient satisfaction in patients undergoing laparoscopic hepatectomy.

Review

Research progress on the prevention and treatment of perioperative sarcopenia in patients with liver cancer

Yang Ning, Zhang Mingming, Wang Haijiao, Wang Xinran

2026, 13(3):  73-76. 

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Patients with liver cancer are at high risk of sarcopenia. This article reviews the concept of sarcopenia, the assessment and diagnosis of sarcopenia in liver cancer patients, and the prevention and treatment measures for sarcopenia in the perioperative period of liver cancer patients. The aim is to provide references for improving the adverse prognosis related to sarcopenia in liver cancer patients and increasing the postoperative survival rate of liver cancer patients.

Nursing field

A study on the correlation of preoperative frailty status with quality of life and prognosis in elderly patients undergoing surgery for hepatocellular carcinoma

Ling Yuanchun, Feng Jinhua, Xu Ruihua, Li Zhenghua, Fan Meiling, Feng Huan, Chen Fang, Han Qiang, Zhao Huijie

2026, 13(3):  77-83. 

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Objective:To assess the preoperative frailty status of elderly patients with liver cancer and explore its relationship with postoperative quality of life and prognosis.
Method:A retrospective cohort study was conducted, in which 85 elderly patients with hepatocellular carcinoma who underwent surgical treatment at West China Hospital, Sichuan University between January 2022 and January 2023 were selected as study subjects using the random number table method. The Fried frailty scale was used to assess the preoperative frailty status of patients. The quality of life scale for liver cancer patients (QOL-LCV2.0) was used to assess the patients' quality of life 3 months after surgery. The relationship between the Fried score and the QOL-LCV2.0 score was analysed using a fitted curve. The relationship between frailty and overall survival rate and recurrence-free survival rate was analysed using the Kaplan-Meier survival curve. Univariate and multivariate Cox risk regression analysis was used to analyse the risk factors for recurrence and death in patients.
Results:Of the 85 elderly patients with liver cancer, 26 (31%) were frail. The frail patients had higher age, diabetes, alcohol consumption, Child-Pugh classification (Grade B), maximum tumour diameter, number of tumours (multiple) and lower body mass index than the non-frail patients (all P<0.05). The length of stay, time to first ambulation and total complication rate of frail patients were higher than those of non- frail patients (all P<0.05). Three months after surgery, the QOL-LCV2.0 score of frail patients was lower than that of non- frail patients (P<0.05). Fitting curve analysis showed that the Fried score was negatively correlated with the QOL-LCV2.0 total score, QOL-LCV2.0 somatic function, QOL-LCV2.0 psychological function, QOL-LCV2.0 adverse symptoms, and QOL-LCV2.0 social support (all P<0.05). The overall survival rate and recurrence-free survival rate of frail patients were lower than those of non-frail patients (all P<0.05). Univariate and multivariate Cox risk regression results showed that frailty was an independent risk factor for recurrence and death in patients (all P<0.05).
Conclusion:Elderly patients with liver cancer have a high risk of preoperative frailty, which is closely related to postoperative low quality of life and poor prognosis.

MDT filed

Summary and analysis of single-center clinical experience with 10 cases of single-port laparoscopic hepatectomy

You Xiao, Lu Zheng, Zhang Dengyong

2026, 13(3):  84-88. 

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Objective:To summarize and analyze the clinical experience of 10 cases of single-port laparoscopic hepatectomy, exploring its safety and feasibility.
Methods:A retrospective analysis was conducted on the clinical data of 10 cases of single-port laparoscopic hepatectomy performed in the Department of Hepatobiliary and Pancreatic Surgery of the First Affiliated Hospital of Bengbu Medical University from August 2024 to July 2025. Among the 10 patients, there were 6 males and 4 females, aged from 38 to 60 years, with an average age of (52.50±6.35) years. There were 5 cases of hepatic hemangioma and 5 cases of hepatocellular carcinoma; the lesions were located in the left lobe of the liver in 6 cases, the right lobe in 3 cases, and involved both lobes in 1 case. The maximum diameter of the lesions ranged from 2 to 6 cm, with an average of (4.22±1.65) cm.
Results:All 10 cases of single-port laparoscopic hepatectomy were successfully completed. The average operation time for the 10 patients was (137.70±41.11) minutes, with the group of hepatic hemangioma averaging (124.60±12.16) minutes and the group of hepatocellular carcinoma averaging (150.80±56.80) minutes. The average intraoperative blood loss was (97.00±56.58) ml, with the group of hepatic hemangioma averaging (84.00±50.30) ml and the group of hepatocellular carcinoma averaging (110.00±65.19) ml. The average postoperative hospital stay was (5.20±1.99) days, with the group of hepatic hemangioma averaging (5.00±1.23) days and the group of hepatocellular carcinoma averaging (5.40±2.70) days. During the follow-up period, all patients experienced no discomfort such as fever or abdominal pain, and their abdominal incisions healed well without redness or exudation.
Conclusions:Single-port laparoscopic hepatectomy has clinical advantages such as safety, feasibility, minimal trauma and rapid recovery in strictly selected cases. The minimally invasive characteristics of single-port laparoscopic hepatectomy can be improved by optimizing the device and designing individualized incisions.