Surgery Plus Systemic Therapy for Liver Cancer With Extrahepatic Metastases

Korábbi kezelés

• Prior systemic therapy for hepatocellular carcinoma, including immunotherapy, targeted therapy, or chemotherapy

Más betegség

• Decompensated or clinically unstable liver disease, including refractory ascites, recurrent hepatic encephalopathy, active gastrointestinal bleeding, or - Child-Pugh class greater than B7
• Major bleeding risk or clinically significant coagulation abnormality, including recent gastrointestinal bleeding or untreated/high-risk gastroesophageal varices
• Active autoimmune disease or long-term systemic immunosuppressive therapy
• Active severe infection, including uncontrolled bacterial or fungal infection, uncontrolled hepatitis B virus replication without appropriate antiviral treatment, or active tuberculosis
• Uncontrolled cardiovascular disease, including poorly controlled hypertension, recent myocardial infarction, unstable angina, stroke, or major thrombotic event
• Another active malignancy, except for selected low-risk malignancies allowed by the investigator and ethics committee
• Known severe hypersensitivity to study-related drugs
• Poor compliance, psychiatric or cognitive disorder preventing study participation, or any other condition judged by the investigator to make the participant unsuitable for the trial

Egyéb

• Uncontrolled central nervous system metastases
• Significant proteinuria or renal dysfunction considered unsuitable for study treatment
• Pregnancy or breastfeeding

• Age 18 to 75 years
• Hepatocellular carcinoma confirmed by imaging and/or histology according to AASLD or EASL criteria
• Resectable primary intrahepatic tumor with expected R0 resection
• ECOG performance status 0 to 1
• At least one measurable extrahepatic metastatic lesion according to RECIST version 1.1
• Child-Pugh class A or stable Child-Pugh B7
• Written informed consent and willingness to comply with study follow-up and data collection