Advances in Locoregional and Systemic Treatments for Hepatocellular Carcinoma.

ICI combinations have significantly improved the overall survivalof patients with unresectable HCC, affording median survival over 2 years and long-term survival exceeding 5 years in a subset of patients.

ICI组合显著提高了不可切除HCC患者的总生存期，中位生存期超过2年，在部分患者中长期生存期超过5年。

Accordingly, there has been increased interest in the earlier application of systemic therapies, including (neo)adjuvant therapy in the perioperative setting or in combination with intra-arterial therapies.

因此，人们对在更早期应用全身性治疗，包括围手术期的（新）辅助治疗或与动脉内治疗相结合的治疗，兴趣增加。

However, recent data failed to demonstrate improved recurrence-free survival with use of adjuvant ICI therapy.

然而，最近的数据未能证明使用辅助ICI治疗可以改善无复发生存期。

Conversely, 2 trials showed improved progression-free survivalwhen ICI therapies were combined with transarterial chemoembolization, although data regarding the impact on overall survivalare still immature.

相反，当ICI疗法与经动脉化疗栓塞联合使用时，有2项试验显示无进展生存期有所改善，尽管关于对总生存影响的数据仍然不成熟。

These improved outcomes raise several new questions, including which patients with liver-localized HCC should receive systemic therapy, how should this be sequenced or combined with other available therapies, and how to manage those patients with marked responses, including consideration of liver transplantation.

这些改善的结果引发了几个新的问题，包括哪些肝局部化的HCC患者应接受系统治疗，应如何安排或与其他可用治疗相结合，以及如何管理那些有显著反应的患者，包括考虑肝移植。

These questions are often determined on a case-by-case basis and best made in a multidisciplinary manner considering several factors, including tumor burden, degree of liver dysfunction, performance status, and patient's long-term goals of care.

这些问题通常需要根据每个病例的具体情况来确定，并且最好通过多学科的方式考虑多个因素，包括肿瘤负担、肝功能损害的程度、患者的生活质量状态以及患者长期护理的目标。