Figure 1.

Proposed strategy for using intraoperative PDT as an adjuvant treatment in liver resection for HCC. (a) Patient’s eligibility criteria for liver resection should be those recommended by the AASLD-EASL international guidelines; (b) prior to the hepatectomy, a PS (or its biological precursor) shall be administered using either loco-regional or systemic route to enhance the tumoral accumulation of the PS; (c) after an optimal drug-to-light interval, the PS generated fluorescence shall be used to identify previously undetected tumors, and to provide a visual aid for the surgeon during hepatectomy; (d) thereafter, at the end of hepatectomy, PDT protocol specific to the PS wavelength and dose shall be initiated onto the tumoral bed to remove any residual tumors; (e) the PDT-induced anti-tumoral immune response might be even more efficient if the patient could subsequently be offered an immune checkpoint blockade-based immunotherapy, thus increasing disease-free survival.