Depth of Radiographic Response as an Independent Prognostic Factor for Patients with Initially Unresectable Hepatocellular Carcinoma Receiving Hepatectomy following Targeted Therapy plus Immunotherapy.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Cancer Pub Date : 2024-09-12 eCollection Date: 2025-04-01 DOI:10.1159/000541300
Bin Xu, Lu-Na Wang, Zi-Yi Wang, Tian He, Xiao-Dong Zhu, Ying-Hao Shen, Jian Zhou, Jia Fan, Hui-Chuan Sun, Cheng Huang
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引用次数: 0

Abstract

Introduction: Surgical resection following systemic therapy is feasible in patients with initially unresectable hepatocellular carcinoma (HCC). However, postoperative tumor recurrence is common after surgery, and the factors affecting this recurrence remain unclear. This study aimed to assess factors influencing postoperative outcomes in patients with initially unresectable HCC undergoing hepatectomy after systemic therapy.

Methods: This study retrospectively enrolled patients with initially unresectable HCC who underwent hepatectomy after targeted therapy plus immunotherapy (with or without locoregional therapy). Multivariate Cox regression analyses were used to identify the independent prognostic factors for recurrence-free survival (RFS) and overall survival (OS). Machine learning was used to determine the RFS rates at different intervals for different radiographic responses.

Results: Eighty-one patients who underwent R0 hepatectomy after systemic therapy were included. With a median follow-up of 17.4 (interquartile range: 7.2-22.3) months, median RFS and OS were not reached. Preoperative tumor downstaging and achieving pathological complete response were associated with improved RFS and OS. Multivariate Cox analyses identified radiographic response as an independent prognostic factor for RFS and OS. Furthermore, a radiographic response >40% (assessed using the Response Evaluation Criteria in Solid Tumors, version 1.1) or >50% (assessed using the modified Response Evaluation Criteria in Solid Tumors) was associated with a longer RFS (p = 0.006 and 0.003, respectively).

Conclusion: Radiographic response depth was an independent prognostic factor in patients with initially unresectable HCC who underwent hepatectomy following targeted therapy plus immunotherapy, and the response to systemic therapy may be the determining factor for patient prognosis after surgery.

放射反应深度作为最初不可切除的肝细胞癌患者接受肝切除术后靶向治疗加免疫治疗的独立预后因素。
简介:对于最初无法切除的肝细胞癌(HCC)患者,全身治疗后手术切除是可行的。然而,术后肿瘤复发是常见的,影响肿瘤复发的因素尚不清楚。本研究旨在评估影响最初不可切除的HCC患者在接受全身治疗后接受肝切除术的术后预后的因素。方法:本研究回顾性纳入了最初不可切除的HCC患者,他们在靶向治疗加免疫治疗(有或没有局部治疗)后接受肝切除术。采用多变量Cox回归分析确定无复发生存期(RFS)和总生存期(OS)的独立预后因素。使用机器学习来确定不同间隔的不同放射反应的RFS率。结果:81例经全身治疗后行R0肝切除术的患者。中位随访时间为17.4个月(四分位数间距:7.2-22.3),中位RFS和OS均未达到。术前肿瘤分期降低和病理完全缓解与RFS和OS的改善相关。多变量Cox分析确定影像学反应是RFS和OS的独立预后因素。此外,放射学反应>40%(使用1.1版实体肿瘤反应评价标准评估)或>50%(使用修改后的实体肿瘤反应评价标准评估)与较长的RFS相关(p分别= 0.006和0.003)。结论:对于最初不可切除的HCC患者,在靶向治疗加免疫治疗后行肝切除术,影像学反应深度是一个独立的预后因素,而对全身治疗的反应可能是患者术后预后的决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Liver Cancer
Liver Cancer Medicine-Oncology
CiteScore
20.80
自引率
7.20%
发文量
53
审稿时长
16 weeks
期刊介绍: Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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