On February 4, 2022, another thing came to mind, which can show that some clinicians are very careless. I previously pointed out the treatment error of a patient with advanced liver cancer, arguing that targets should not be used on the front line

February 4, 2022 Another thing that reminds me is that some clinicians are very careless.

I previously pointed out the treatment error of a patient with advanced liver cancer, arguing that targeted plus immunotherapy should not be used on the first line. A surgeon at a top three hospital was very excited and jumped out to accuse me of low level, saying that according to the guidelines, this is the best treatment.

I was wondering how this doctor would look at the guide. So I communicated for a while to understand the problem.

Liver cancer is divided into many types, the most common is hepatocellular carcinoma, and there is intrahepatic cholangiocarcinoma, which are the basics. Although this patient is advanced liver cancer, he is a cholangiocarcinoma in the liver. First-line targeting and immunity are the gold standard for hepatocellular carcinoma, without any problems, but are not suitable for intrahepatic bile duct cell carcinoma.

As a result, the doctor actually believes that hepatocellular carcinoma and intrahepatic cholangiocarcinoma are the same disease and suitable for the same treatment. Actually there was a significant difference, and when I pointed it out, he was silent.

Clinically, there are many doctors who believe that hepatocellular carcinoma, intrahepatic cholangiocarcinoma, hepatic hilar bile duct cell carcinoma and distal bile duct carcinoma should all be the same treatment, including the drugs used.

I need to say: doctors can't be so careless, these are not the same diseases, the treatment that needs to be received is not the same.