Abstract
Primary liver cancer is a major public health issue in China, with high incidence and mortality rates. Notably, progress has been made in improving the surgical methods and hepatic arterial infusion chemotherapy (HAIC) regimens of liver cancer and the combination of HAIC with immunotherapy is expected to further increase the surgical conversion rate or objective response rate. However, patients with liver cancer often have underlying cirrhosis, which may lead to complications, such as esophageal varices and high-pressure gastric diseases. The present study describes three cases of giant gastric ulcers that occurred during the process of HAIC or combined immunotherapy. Notably, the causal relationship between HAIC and immunotherapy is unclear. In patients with tumors receiving immunotherapy, gastrointestinal adverse reactions are common, and some may develop serious complications, such as gastrointestinal perforation. The present study provides a detailed analysis of this issue and emphasizes the need for further clarification of its mechanisms and effective treatment methods.