In the 20th century, major progresses were made for treatment of hepatocellular carcinoma: standard resection, radiotherapy and chemotherapy were applied in the 1950s; liver transplantation emerged in the 1960s, and the positive clinical results for the treatment of hepatocellular carcinoma were proved in the 1990s; the survival rates were significantly increased due to local resection for small liver cancer in the 1970s and local tumor therapies benefited the patients more in the 1980s. But the purpose of these procedures was only to destroy the tumors. In the past half century, the survival rate of liver cancer patients in our hospital increased every ten years. It is predicted that in the 21st century, the purpose of improving the outcome of treatment for liver cancer will elaborate to manipulating procedures between tumor and the human body on the basis of destroying the tumors. There are various ways to improve the therapeutic results for hepatocellular carcinoma. For example, these efforts can be achieved by developing and using new therapeutic methods. In the early 21st century, further biological study is the key point to influence the clinical progress for hepatocellular carcinoma. Although to destroy the tumors is basic and important, the most important thing is how to regulate the relationship between residual tumors and the human body.%20世纪提高肝癌疗效的努力主要有:50年代肝癌规则性切除和放、化疗的应用;60年代肝移植问世,到90年代其治疗肝癌的价值得到了肯定;70年代小肝癌的局部切除使切除疗效倍增;80年代局部治疗扩大了肝癌病人的受益面.这些努力的目标就是"消灭肿瘤".过去半个世纪来每个10年我所住院肝癌病人的生存率都有所提高.预期21世纪提高肝癌疗效的目标将从单纯消灭肿瘤变为消灭肿瘤基础上加上调变肿瘤和机体.提高肝癌疗效有多种途径.有些途径疗效提高的幅度较大,如早诊早治;有些研究提高疗效的幅度较小,如肝癌手术切端远近的研究.有些是实质性提高疗效,如新疗法的研究与应用;有些则是限于肝癌某一亚群疗效的提高,如某一疗法适应证的研究.在21世纪初,生物学将是影响肝癌临床进步的关键因素.尽管消灭肿瘤依然是主要的、基本的,但是对残癌与机体的调变则是进一步提高疗效的关键.
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