Hepatology International最新文献

{"title":"Efficacy of measuring natural killer-activating receptor ligands to predict the pathogenesis of metabolic dysfunction-associated steatotic liver disease.","authors":"Jun Arai, Akinori Okumura, Satoshi Kimoto, Kazumasa Sakamoto, Tomoya Kitada, Rena Kitano, Tadahisa Inoue, Sayaka Nishimura, Noriko Inden, Yukiko Muraki, Naoya Kato, Kiyoaki Ito","doi":"10.1007/s12072-025-10800-y","DOIUrl":"https://doi.org/10.1007/s12072-025-10800-y","url":null,"abstract":"<p><strong>Objective: </strong>The proportion of non-B/non-C hepatocellular carcinoma cases is increasing, and the principal cause is metabolic dysfunction-associated steatotic liver disease (MASLD). The degree of intrahepatic natural killer (NK) cell infiltration has been reported to correlate with MASLD progression. However, reports on MASLD are limited. We aimed to investigate the involvement of NK cell-activating receptor ligands in MASLD pathogenesis.</p><p><strong>Methods: </strong>This study cohort comprised 69 patients with biopsy-proven MASLD treated between 2012 and 2018 at our institute. The concentrations of major histocompatibility complex class I polypeptide-related sequences A and B (MICA and MICB, respectively) and B7H6 in patient sera were measured using enzyme-linked immunosorbent assay kits. Data were statistically compared between those with metabolic-associated steatotic liver (MASL, n = 25) and those with metabolic dysfunction-associated steatohepatitis (MASH, n = 44). The clinical characteristics related to higher concentrations of each NK cell-activating receptor ligand were also investigated.</p><p><strong>Results: </strong>The MASH group had a higher level of the ligands than the MASL group. Furthermore, the MASH group had a significantly higher level of the Mac-2-binding protein glycosylation isomer (M2BPGi) than the MASL group (p < 0.001). MICA and MICB were positively correlated, and all three ligands were strongly correlated with alpha-fetoprotein and protein induced by vitamin K absence 2. Although MICB levels positively correlated with aspartate transaminase and alanine transaminase levels (p < 0.005), patients with higher MICA and B7H6 levels had higher M2BPGi levels. Interestingly, concentrations of B7H6 were significantly correlated with portal inflammation (p < 0.001), rather than lobular inflammation.</p><p><strong>Conclusion: </strong>The three NK-activating receptor ligands were higher in the sera of the MASH group than those of the MASL group and strongly correlated with tumor markers, indicating the potential for hepatocarcinogenesis. Higher concentrations of serum B7H6 were correlated with advanced fibrosis and the degree of portal inflammation, which is a potential biomarker for predicting the pathogenesis of MASH.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and outcomes of early and late recurrence after hepatectomy for hepatocellular carcinoma with microvascular invasion: a multicenter study in China.","authors":"Xiu-Ping Zhang, Tian-Chen Zhang, Fei-Fan Wu, Zhen-Qi Li, Zhao-Hui Xiao, Ze-Tao Yu, Kang Wang, Shuai Xu, Tao Jiang, Chao Lin, Xiong Chen, Guang Tan, Nian-Xin Xia, Wen-Chao Zhao, Mao-Lin Yan, Yun-Fei Xu, Xiao-Dong Tan, Jian-Hua Lin, Yun-Tao Ma, Yu-Fu Tang, Qing-Qiang Ni, Yi-Lin Hu, Yi-Ren Hu, Kai Wang, Fan Zhang, Qing-Lun Gao, Rui-Fang Fan, Zhi-Qiang Wang, Zi-Li Chen, Yi-Meng Lu, Hong-Xing Jiang, Zhong-Hua Liu, Shu-Qun Cheng, Ming-Gen Hu, Rong Liu","doi":"10.1007/s12072-025-10802-w","DOIUrl":"10.1007/s12072-025-10802-w","url":null,"abstract":"<p><strong>Background: </strong>A few studies focus on the long-term outcomes and surveillance strategies for patients with hepatocellular carcinoma (HCC) and microvascular invasion (MVI) who experience postoperative recurrence. The aim of this study was to explore the patterns and prognosis of early and late recurrence (ER and LR) after hepatectomy of such patients.</p><p><strong>Methods: </strong>Consecutive patients with HCC and MVI after hepatectomy from 26 centers in China from 2009 to 2020 were included. Overall survival (OS) and post-recurrence survival (PRS) were compared using the Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>Of 2828 included patients, 1200 patients developed ER and 607 patients developed LR. Among patients with recurrence, 1166 patients had intra-hepatic recurrence as the primary site of first recurrence. The median OS times for the ER, LR, and non-recurrence groups were 20.2, 52.6, and 58.9 months, respectively. Besides, patients with ER had shorter PRS (14.3 vs. 18.9 months, p < 0.001) than LR. Compared to extra-hepatic and both intra- and extra-hepatic recurrence, intra-hepatic recurrence had better OS and PRS (p < 0.001). Recurrence patients who underwent regular postoperative surveillance had longer OS (37.1 vs. 23.4 months, p < 0.001) and PRS (21.2 vs. 11.9 months, p < 0.001) compared to those with irregular surveillance.</p><p><strong>Conclusions: </strong>Patients with HCC and MVI are more likely to develop ER within 1 year, and ER has a worse prognosis compared to LR. Intra-hepatic is the predominant recurrence site in ER and LR. Postoperative surveillance can improve survival outcomes in patients with recurrence.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of tenofovir alafenamide in the context of hyperlipidemia and cardiovascular diseases: a nationwide analysis.","authors":"Jae-Young Kim, Hyuk Kim, Jeong-Ju Yoo, Sang Gyune Kim, Young-Seok Kim","doi":"10.1007/s12072-025-10809-3","DOIUrl":"https://doi.org/10.1007/s12072-025-10809-3","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous small-scale studies, the correlation between tenofovir alafenamide fumarate (TAF) and hyperlipidemia remains still limited. This study aims to evaluate the safety of TAF regarding hyperlipidemia and cardiovascular diseases using a nationwide cohort.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of claims data from the Health Insurance Review and Assessment Service, comparing incidence rates of hyperlipidemia and major adverse cardiovascular events (MACE) using 1:1 propensity score matching between TAF and tenofovir disoproxil fumarate (TDF) users.</p><p><strong>Results: </strong>The incidence of hyperlipidemia among TAF users was 21.38 per 1000 person-years, compared to 10.04 among TDF users. The incidence rate ratio (IRR) was 2.13 (95% confidence interval [CI] 1.92-2.36), indicating a significantly higher incidence in TAF users compared to TDF users (p < 0.001). After adjusting for other factors, Cox regression analysis showed that TAF was significantly associated with hyperlipidemia compared to TDF (hazard ratio [HR] 1.99, 95% CI 1.79-2.20, p < 0.001). There was no significant difference in the incidence of MACE between TDF and TAF users (2.19 per 1,000 person-years for TDF and 2.25 per 1,000 person-years for TAF, IRR 1.02, 95% CI 0.79-1.33, p = 0.853), with Cox regression analysis showing no disparity between the groups (HR 1.03, 95% CI 0.78-1.36, p = 0.829).</p><p><strong>Conclusions: </strong>TAF is associated with a higher incidence of hyperlipidemia than TDF. While the incidence of MACE in the TAF group has not shown a significant increase compared to the TDF group, further investigation into long-term outcomes is warranted. Lipid monitoring in TAF and TDF patients is essential for managing risks and reducing cardiovascular complications.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a reliable prognostic nomogram for surgical hepatocellular carcinoma: unanswered questions.","authors":"Teh-Ia Huo, Shu-Yein Ho","doi":"10.1007/s12072-025-10808-4","DOIUrl":"https://doi.org/10.1007/s12072-025-10808-4","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis in upper gastrointestinal bleeding with Child-Pugh A cirrhosis: need for objective infection markers and broader studies.","authors":"Bin Hu","doi":"10.1007/s12072-025-10810-w","DOIUrl":"https://doi.org/10.1007/s12072-025-10810-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of plasma exchange on bilirubin reduction and neurological impairment in infantile acute liver failure.","authors":"Kentaro Ide, Hajime Uchida, Seisuke Sakamoto, Itaru Hayakawa, Vipul Gautam, Satoshi Nakagawa, Mureo Kasahara","doi":"10.1007/s12072-025-10807-5","DOIUrl":"https://doi.org/10.1007/s12072-025-10807-5","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The benefit of conversion therapy for patients with unresectable hepatocellular carcinoma receiving atezolizumab plus bevacizumab using newly established oncological resectability criteria in Japan.","authors":"Shigeo Shimose, Issei Saeki, Takanori Ito, Yasuto Takeuchi, Joji Tani, Tetsu Tomonari, Ryu Sasaki, Kyo Sasaki, Satoru Kakizaki, Takeshi Hatanaka, Hideki Iwamoto, Norikazu Tanabe, Takafumi Yamamoto, Atsushi Naganuma, Tomotake Shirono, Yuki Kanayama, Sohji Nishina, Tetsuji Takayama, Hideki Kobara, Motoyuki Otsuka, Hiroki Kawashima, Taro Takami, Takumi Kawaguchi","doi":"10.1007/s12072-025-10781-y","DOIUrl":"https://doi.org/10.1007/s12072-025-10781-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the changes in oncological resection status in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev) and the impact of conversion therapy following Atez/Bev treatment.</p><p><strong>Methods: </strong>This cohort included 631 patients with u-HCC treated with Atez/Bev. Tumors were assessed using oncological resectability criteria and categorized as borderline resectable 1 (BR1, n=166) or borderline resectable 2 (BR2, n=465).</p><p><strong>Results: </strong>Overall, 129 (20.4%) patients were downstaged based on oncological resectability criteria. Among them, 28 (16.8%) patients were downstaged from BR1 to resectable (R), and 49 (10.5%) and 52 (11.1%) patients were downstaged from BR2 to R and from BR2 to BR1, respectively. The percentage of patients who underwent conversion therapy was 5.4%. For patients categorized as BR1 and BR2 before Atez/Bev treatment, the rates of conversion therapy were 8.4% (14/166) and 4.3% (20/465), respectively. Overall survival (OS) was significantly higher in the conversion therapy group than in the partial response group (not reached vs. 36.4 months, p=0.001), with no significant differences compared to the complete response group. The median recurrence-free survival was 15.7 months after conversion therapy. Although there were differences in patient background data at the time of conversion therapy, surgery had a significantly higher RFS than radiofrequency ablation (not reached vs. 10.0 months, p=0.008).</p><p><strong>Conclusions: </strong>When feasible, conversion therapy should be considered to improve the prognosis of u-HCC patients treated with Atez/Bev. Moreover, oncological resectability criteria may provide a useful tool for investigators regarding conversion therapy.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risk factors for immune checkpoint inhibitor-associated liver injury: a retrospective analysis based on clinical study and real-world data.","authors":"Bitao Wang, Shaowei Zhuang, Shengnan Lin, Jierong Lin, Wanxian Zeng, Bin Du, Jing Yang","doi":"10.1007/s12072-025-10783-w","DOIUrl":"https://doi.org/10.1007/s12072-025-10783-w","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated hepatotoxicity (IMH) induced by immune checkpoint inhibitors (ICIs) can lead to fatal outcomes. Exploring the risk factors associated with IMH is crucial for the early identification and management of immune-related adverse events (irAEs).</p><p><strong>Methods: </strong>Screening IMH-influencing factors by applying meta-analysis to clinical research data. Utilizing FAERS data, ICIs-related IMH prediction models were developed using two types of variables (full variables and optimal variables screened by univariate logistic regression) and nine machine learning algorithms (logistic regression, decision tree, random forest, gradient boosting decision tree, extreme gradient boosting, K-Nearest Neighbor, bootstrap aggregation, adaptive boosting, and extremely randomized trees). Comparing the nine machine learning algorithms and screening the optimal model while using SHAP (SHapley Additive exPlanations) analysis to interpret the results of the optimal machine learning model.</p><p><strong>Results: </strong>A total of 17 studies (10,135 patients) were included. The results showed that ICIs combination therapy (OR = 5.10, 95% CI: 1.68-15.48) and history of ICIs treatment (OR = 3.58, 95% CI: 2.08-6.14) were significantly associated with the risk of all-grade IMH. Patients aged 56-63 years (MD = - 5.09, 95% CI: - 9.52 to - 0.67) were significantly associated with the risk of ≥ grade 3 IMH. The liver adverse reaction prediction model included a total of 51,555 patients from the FAERS database, of which 4607 cases were liver adverse reactions. Univariate logistic regression analysis ultimately screened eight optimal variables, with females, report areas, cancer type, ICIs drug type, concomitant autoimmune disease, the concomitant use of anti-hypertension drugs, and the concomitant use of CTLA-4 inhibitors or targeted therapy drugs being significant influencing factors. The performance of the model after the variables were screened by univariate logistic regression was slightly worse than that of the model with full variables. Among the best-performing liver adverse reaction prediction models was GBDT (training set AUC = 0.82, test set AUC = 0.79). The top 3 key predictors in the GBDT model were report areas, disease type, and ICIs drug type.</p><p><strong>Conclusion: </strong>In clinical studies, we found that age between 56 and 63 years, ICIs combination therapy, and history of ICIs treatment were significantly associated with an increased risk of IMH. In the FAERS database, we observed that females, report areas, cancer type, ICIs drug type, concomitant autoimmune disease, the concomitant use of anti-hypertension drugs, and the concomitant use of CTLA-4 inhibitors or targeted therapy drugs may be potential risk factors for ICIs-related hepatic irAEs. The predictive model for ICIs-related liver adverse reactions established in this study has good performance and potential clinical applications.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury stage 1a increases mortality of patients with cirrhosis: a prospective multicenter cohort study.","authors":"Ângelo Z Mattos, Caroline Machado Rotta Dornelles, Leonardo de Lucca Schiavon, Liliana Sampaio Costa Mendes, Roberto José de Carvalho Filho, Liana Codes, Alberto Queiroz Farias, Mário Reis Álvares-da-Silva, Carlos Terra, Gustavo Pereira, Muriel Manica, Helena Marcon Bischoff, Janaína Luz Narciso-Schiavon, Silas Gustavo Barboza Romeres, Jéssica Bastos Garcia, Paulo Lisboa Bittencourt, Rafael Oliveira Ximenes, Raul Salinas Arrojo, Angelo A Mattos","doi":"10.1007/s12072-025-10790-x","DOIUrl":"https://doi.org/10.1007/s12072-025-10790-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute kidney injury is a severe complication of cirrhosis. However, the impact of mild decreases in renal function is controversial. This study aims to evaluate the prognosis of the different stages of acute kidney injury in cirrhosis.</p><p><strong>Methods: </strong>This is a multicenter prospective cohort study of patients hospitalized for acute decompensation of cirrhosis, with serum creatinine values measured at least twice. Primary outcome was mortality (in-hospital, 30 days, 90 days and 12 months).</p><p><strong>Results: </strong>Nine hundred twenty-eight patients were included in the study. Acute kidney injury was diagnosed in 505 patients (stages 1a-21.6%, 1b-27.5%, 2-28.1%, 3-22.8%). Mortality rates of patients with acute kidney injury stage 1a were significantly higher than those of individuals without acute kidney injury (in-hospital-19.3% vs 4.7%; 30-day-21.8% vs 6.7%; 90-day-35.2% vs 17.5%; 12-month-54.1% vs 37.1%; p < 0.05 for all comparisons). Mortality rates were even higher for acute kidney injury stages 1b, 2 and 3. Survival analysis demonstrated that patients without acute kidney injury performed significantly better than those with any stage of acute kidney injury (p < 0.01). Acute kidney injury stages 1a, 1b, 2 and 3 were independently associated with survival in the multivariate analysis (p < 0.01).</p><p><strong>Conclusions: </strong>Patients hospitalized for acute decompensation of cirrhosis who develop acute kidney injury have significantly higher mortality rates than those who do not develop this complication. This is true even for the mildest stages of acute kidney injury (stage 1a) and remains so at different time-points, supporting recommendations for earlier treatments.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of neutrophil-to-lymphocyte ratio in recurrent HCC after repeat hepatectomy or salvage liver transplantation.","authors":"Jiafeng Chen, Yuan Fang, Zheng Tang, Enfu Dong, Jun Gao, Guiqi Zhu, Pascal Kwangwari, Shanru Feng, Weifeng Qu, Xiaoling Wu, Shengwei Mao, Qianfu Zhao, Yi Wang, Rui Yang, Zhiqi Guan, Tianhao Chu, Yichao Bu, Jian Zhou, Jia Fan, Xiutao Fu, Weiren Liu, Zhenbin Ding, Yinghong Shi","doi":"10.1007/s12072-025-10786-7","DOIUrl":"https://doi.org/10.1007/s12072-025-10786-7","url":null,"abstract":"<p><strong>Backgrounds and aims: </strong>Hepatocellular carcinoma (HCC) is the most prevalent type of primary liver cancer, characterized by a high rate of recurrence. This study aims to compare the efficacy and safety of repeat hepatectomy (RH) and salvage liver transplantation (sLT) for recurrent hepatocellular carcinoma (rHCC) and explores the predictive value of neutrophil-to-lymphocyte ratio (NLR) and neutrophil extracellular traps (NETs).</p><p><strong>Methods: </strong>In this study, consecutive patients receiving RH (n = 637) or sLT (n = 53) for rHCC within the University of California San Francisco (UCSF) Criteria were recruited. After propensity score matching (PSM), disease-free survival (DFS) and overall survival (OS) were compared utilizing the Kaplan-Meier method. Additionally, the level of neutrophil infiltration and NETs were analyzed by multiplex immunofluorescence.</p><p><strong>Results: </strong>After PSM, the sLT group demonstrated superior 5-year DFS and OS compared to the RH group (p < 0.001 and p = 0.014). Subgroup analysis demonstrated that NLR > 2.3 was associated with poorer OS (p < 0.001 in the RH group and p = 0.024 in the sLT group) and DFS (p = 0.002 in both groups). Furthermore, we identified that patients in the sLT group are more susceptible to extrahepatic metastasis. In addition, our results revealed that higher infiltration of intratumoral neutrophils was negatively correlated with OS and DFS (p = 0.002 and p = 0.001, respectively), especially in cases with higher NETs level.</p><p><strong>Conclusions: </strong>This study indicates that sLT achieves better long-term outcomes than RH for rHCC. NLR and NETs formation are promising prognostic factors for HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}