Hepatology Research最新文献

{"title":"Simplified BALAD (BALAD-S) Score as a Guide for First-Line Immune Checkpoint Inhibitor Selection for Unresectable Hepatocellular Carcinoma.","authors":"Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Takashi Nishimura, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hidenori Toyoda, Chikara Ogawa, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Hironori Tanaka, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Hideyuki Tamai, Shohei Komatsu, Yoshihide Ueda, Soo Ki Kim, Shintaro Takaki, Fujimasa Tada, Hideko Ohama, Shinichiro Nakamura, Takanori Matsuura, Yoshiko Nakamura, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Takuya Nagano, Kazunari Tanaka, Yuichi Koshiyama, Yuki Kanayama, Hidenao Noritake, Jumpei Okamura, Hirayuki Enomoto, Kosuke Matsui, Masaki Kaibori, Tamami Abe, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada","doi":"10.1111/hepr.70239","DOIUrl":"https://doi.org/10.1111/hepr.70239","url":null,"abstract":"<p><strong>Background and aim: </strong>Atezolizumab plus bevacizumab (Atez/Bev) and durvalumab plus tremelimumab (Dur/Tre) are widely used first-line immune checkpoint inhibitor (ICI)-based regimens for unresectable hepatocellular carcinoma (uHCC). However, reliable biomarkers to inform treatment choice remain limited. This study evaluated whether the simplified BALAD-based score (BALAD-S) is associated with differential treatment outcomes.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included 752 Japanese patients with uHCC who received first-line Atez/Bev (n = 645) or Dur/Tre (n = 107) between October 2020 and March 2026. BALAD-S was calculated using bilirubin, albumin, AFP, AFP-L3, and des-γ-carboxy prothrombin, and patients were stratified into BALAD-S low (≤ 2) and high (≥ 3) groups. Treatment response, progression-free survival (PFS), and overall survival (OS) were evaluated.</p><p><strong>Results: </strong>In the BALAD-S low group, Atez/Bev showed longer PFS than Dur/Tre (10.5 vs. 4.3 months; p < 0.001), with longer OS also observed (28.3 vs. 19.4 months; p = 0.049). In the BALAD-S high group, PFS did not differ significantly (7.0 vs. 5.3 months with Dur/Tre and Atez/Bev, respectively, p = 0.210), whereas OS was longer with Dur/Tre than with Atez/Bev (27.3 vs. 16.4 months; p = 0.022). Treatment effects differed by BALAD-S category (HR for Dur/Tre vs. Atez/Bev: 1.50 in BALAD-S low and 0.55 in BALAD-S high; p for interaction = 0.005). In patients treated from 2023 onward, similar treatment-effect heterogeneity was observed (HR 1.61 in BALAD-S low and 0.59 in BALAD-S high; p for interaction = 0.007).</p><p><strong>Conclusion: </strong>Outcomes with Atez/Bev and Dur/Tre differed according to BALAD-S score. BALAD-S may help identify patients with differential outcomes between first-line ICI-based regimens and represents a candidate stratification marker requiring validation.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avacopan-Associated Hepatobiliary Adverse Events and Vanishing Bile Duct Syndrome: A PMDA/JADER and FAERS Reporting-Profile Comparison.","authors":"Hiroteru Kamimura, Makoto Miyazawa, Shota Kaneko, Yoshihiro Uesawa, Daisuke Kobayashi, Suguru Yamamoto, Shuji Terai","doi":"10.1111/hepr.70242","DOIUrl":"https://doi.org/10.1111/hepr.70242","url":null,"abstract":"<p><strong>Aim: </strong>Avacopan is an oral C5a receptor antagonist approved for anti-neutrophil cytoplasmic antibody-associated vasculitis. Recent post-marketing safety information has raised concern regarding serious hepatobiliary injury, including vanishing bile duct syndrome (VBDS). We compared Japanese and FAERS post-marketing reporting profiles for avacopan-associated adverse events.</p><p><strong>Methods: </strong>FAERS public dashboard data and PMDA CSV data downloaded in May 2026 were searched using Japanese and English avacopan/Tavneos terms and analyzed at the case report and adverse-event/preferred-term row levels. FAERS Public Dashboard aggregate data were searched using the avacopan generic-name listing as the primary definition and the Tavneos product-name listing as a sensitivity definition.</p><p><strong>Results: </strong>PMDA/JADER contained 397 avacopan-related reports and 744 adverse-event/preferred-term rows. FAERS contained 5770 reports in the avacopan generic-name listing and 5216 reports in the Tavneos product-name listing. Hepatobiliary preferred terms were prominent in PMDA/JADER, including hepatic function abnormal (n = 86), liver disorder (n = 44), drug-induced liver injury (n = 40), and VBDS (n = 29). Among PMDA/JADER VBDS reports with available dates, the median time to onset was 44.0 days (interquartile range, 39.5-52.0).</p><p><strong>Conclusions: </strong>Post-marketing reports of avacopan-associated hepatobiliary injury, including VBDS, warrant clinical attention, particularly during the early treatment period. PMDA/JADER and FAERS findings should be interpreted as differences in reporting profiles rather than direct comparisons of incidence or risk.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pemafibrate Improves Cholestatic Markers Regardless of the Presence of Primary Biliary Cholangitis.","authors":"Ryohei Tanigawa, Yoshiyuki Ueno, Hirokazu Takahashi, Ayumi Saito, Hideki Suganami, Atsushi Tanaka","doi":"10.1111/hepr.70244","DOIUrl":"https://doi.org/10.1111/hepr.70244","url":null,"abstract":"<p><strong>Background and aim: </strong>Pemafibrate, a selective PPARα modulator (SPPARMα), improves cholestatic liver enzymes in primary biliary cholangitis (PBC). However, whether these effects depend on PBC-specific autoimmune mechanisms or reflect broader anti-cholestatic actions remains unclear. This study evaluated the effects of pemafibrate on cholestatic markers by PBC status and explored bile acid and immunological changes in patients with PBC.</p><p><strong>Methods: </strong>This post hoc analysis used data from a 52-week phase III study of pemafibrate in patients with hypertriglyceridemia, including 9 with PBC. Cholestatic markers (ALP, total bilirubin, GGT, and LAP) were assessed serially. Linear regression examined associations between baseline levels and response by PBC status. In patients with PBC, bile acids, FGF19, FGF21, C4, IgM, IgG, and M2BPGi were also evaluated.</p><p><strong>Results: </strong>Pemafibrate significantly reduced all cholestatic markers from week 4-52, regardless of the presence of PBC. Greater reductions were observed in patients with higher baseline levels. In patients with PBC, C4 decreased without significant change in FGF19, suggesting suppression of de novo bile acid synthesis independent of intestinal feedback. The bile acid profile shifted toward a more hydrophilic composition with reduced hydrophobic species. IgM, IgG, and M2BPGi decreased, whereas FGF21 increased.</p><p><strong>Conclusions: </strong>Pemafibrate improved cholestatic markers in a baseline-dependent manner, regardless of the presence of PBC, suggesting mechanisms beyond PBC-specific pathology. These findings support a broader anti-cholestatic effect, potentially mediated by coordinated modulation of bile acid metabolism and immunological activity through PPARα activation.</p><p><strong>Trial registration: </strong>The trials were registered at ClinicalTrials.gov under the identifiers NCT04716595.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Risk-Estimation Model for Identifying Patients at Risk of Early Skeletal Muscle Mass Loss in Chronic Liver Disease.","authors":"Atsushi Hiraoka, Hideko Ohama, Fujimasa Tada, Kazuhiro Tange, Osamu Yoshida, Masashi Hirooka, Masanori Abe, Tomoyuki Ninomiya, Sachiyo Yoshio, Yoichi Hiasa","doi":"10.1111/hepr.70245","DOIUrl":"https://doi.org/10.1111/hepr.70245","url":null,"abstract":"<p><strong>Background and aim: </strong>Sarcopenia is associated with poor outcomes in patients with chronic liver disease (CLD), but current screening based on reduced muscle strength may fail to identify early skeletal muscle loss. This study aimed to develop a risk-estimation model for identifying patients at risk of early skeletal muscle mass loss before patients meet the diagnostic criteria for overt sarcopenia.</p><p><strong>Methods: </strong>This retrospective study included 1276 CLD patients who underwent handgrip strength testing and computed tomography-based skeletal muscle index (SMI) assessment between 2015 and 2026. SMI ratio and grip ratio were defined as relative deviations from sex-specific reference values established by the Japan Society of Hepatology. Early skeletal muscle mass loss was defined as an SMI ratio < 0.05. A multivariable logistic regression model incorporating grip ratio, age, sex, platelet count, albumin-bilirubin score, creatinine, body mass index, hepatocellular carcinoma status, and the interaction between grip ratio and sex was developed (MYO-SCAN score).</p><p><strong>Results: </strong>The model demonstrated good discrimination for identifying patients with an SMI ratio < 0.05 with an area under the receiver operating characteristic curve (AUC) of 0.847. The optimal cutoff value was 0.435, yielding sensitivity and specificity of 0.777 and 0.764, respectively. Risk-estimation performance was significantly superior to grip ratio alone (AUC 0.847 vs. 0.614, p < 0.001). Bootstrap validation showed minimal optimism with an optimism-corrected AUC of 0.843.</p><p><strong>Conclusion: </strong>The MYO-SCAN score may facilitate early identification of CLD patients at risk of skeletal muscle mass loss, including those who may be overlooked by grip-strength-based screening.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Underweight and Adulthood Obesity Associated With Increased Risk of MASLD and Cirrhosis: A Prospective Cohort Study of 375,125 Adults.","authors":"Jiadong Zeng, Jian Liang, Hao Zhang, Hanming Wang, Zheyang Lin, Wenzhe Zhang, Haobin Zhang, Xudong Deng, Jiahui Lin, Minqi Liu, Minwen Chen, Yue Qiu, Zhen Zhang, Zhaohua Zhu, Yi Zeng","doi":"10.1111/hepr.70238","DOIUrl":"https://doi.org/10.1111/hepr.70238","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a known risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD) and cirrhosis, but the long-term effects of childhood thinness and body size changes across life are unclear. We aimed to assess how body size and child-to-adult body size trajectories relate to major liver outcomes.</p><p><strong>Methods: </strong>We studied 375,125 UK Biobank participants without liver disease at baseline. Childhood body size (thinner, average, and plumper) and adulthood body size (normal, overweight, and obesity) were combined into nine trajectories. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MASLD and cirrhosis. Kaplan-Meier survival curves assessed the association between body size trajectories and liver diseases. Sensitivity and subgroup analyses tested robustness.</p><p><strong>Results: </strong>Compared with average childhood body size, childhood thinness was associated with higher risks of MASLD (HR 1.18, 95% CI 1.11-1.27) and cirrhosis (HR 1.15, 95% CI 1.03-1.27). Relative to persistently normal body size, the \"thinner to obesity\" trajectory showed the greatest risks of MASLD (HR 3.95, 95% CI 3.29-4.76) and cirrhosis (HR 3.97, 95% CI 3.30-4.77). The \"plumper to normal\" trajectory was not associated with increased MASLD or cirrhosis.</p><p><strong>Conclusion: </strong>Childhood thinness is associated with increased risks of MASLD and cirrhosis in adulthood. Achieving a normal BMI in adulthood may mitigate liver-related risks linked to childhood overweight.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Number of Remaining Natural Teeth on Decompensation and Survival in Patients With Compensated Liver Cirrhosis.","authors":"Tatsuya Nakatani, Tadashi Namisaki, Hiroaki Takaya, Takashi Inoue, Akihiko Shibamoto, Satoshi Iwai, Masafumi Oyama, Junichi Hanatahi, Naoki Nishimura, Yuki Tsuji, Yukihisa Fujinaga, Shinya Sato, Norihisa Nishimura, Koh Kitagawa, Kosuke Kaji, Akira Mitoro, Takemi Akahane, Hitoshi Yoshiji","doi":"10.1111/hepr.70243","DOIUrl":"https://doi.org/10.1111/hepr.70243","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the impact of oral health, measured by the number of remaining natural teeth, on hepatic decompensation and survival in patients with compensated liver cirrhosis.</p><p><strong>Methods: </strong>This retrospective cohort study included 106 patients with Child-Pugh class A cirrhosis who were followed longitudinally until March 2024. Patients were stratified by number of remaining natural teeth with fewer than 20 teeth classified as poor oral health according to the concept of functional dentition. Cox proportional hazards models were used to identify factors associated with hepatic decompensation and overall survival. Associations between tooth number, sarcopenia, and endotoxin activity were also evaluated.</p><p><strong>Results: </strong>During follow-up, 26 patients developed hepatic decompensation and 26 died. Kaplan-Meier analysis showed that patients with fewer than 20 remaining natural teeth had significantly higher rates of hepatic decompensation and poorer overall survival than those retaining 20 or more teeth. In multivariate analysis, fewer than 20 teeth were independently associated with hepatic decompensation (hazard ratio [HR]: 2.46; 95% confidence interval [CI], 1.08-5.40; p = 0.032) and mortality (HR: 2.32; 95% CI, 1.01-5.34; p = 0.048). Patients with fewer teeth exhibited a higher prevalence of sarcopenia and significantly increased endotoxin activity.</p><p><strong>Conclusions: </strong>Severe tooth loss was independently associated with hepatic decompensation and mortality in compensated cirrhosis. Oral health assessment using the number of remaining natural teeth may provide a simple and clinically valuable tool for prognostic stratification in patients with cirrhosis.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Comment on 'Using Serum Creatinine-To-Cystatin C Ratio to Predict Sarcopenia in Patients With Liver Cirrhosis'\".","authors":"Akihiko Shibamoto, Tadashi Namisaki, Masayoshi Takami, Hiroyuki Masuda, Takashi Inoue, Satoshi Iwai, Shohei Asada, Yuki Tsuji, Yukihisa Fujinaga, Shinya Sato, Norihisa Nishimura, Koh Kitagawa, Hiroaki Takaya, Kosuke Kaji, Akira Mitoro, Kiyoshi Asada, Hitoshi Yoshiji","doi":"10.1111/hepr.70237","DOIUrl":"https://doi.org/10.1111/hepr.70237","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic Analysis of Serum Extracellular Vesicles Revealed Fibulin-3 as a Novel Predictive Biomarker for Hepatocellular Carcinoma in Patients With Chronic Hepatitis B.","authors":"Emi Sometani, Kazuhiro Murai, Hayato Hikita, Jihyun Sung, Satoshi Muraoka, Hidenori Toyoda, Satoshi Tanaka, Takayuki Miyake, Shinji Kuriki, Kenji Fukumoto, Satoshi Shigeno, Yuta Myojin, Kazuki Maesaka, Kumiko Shirai, Yuki Makino, Yuki Tahata, Yoshinobu Saito, Takahiro Kodama, Ryotaro Sakamori, Jun Adachi, Tomomi Yamada, Tetsuo Takehara","doi":"10.1111/hepr.70234","DOIUrl":"https://doi.org/10.1111/hepr.70234","url":null,"abstract":"<p><strong>Background and aim: </strong>Although nucleos(t)ide analog (NUC) therapy reduces hepatocellular carcinoma (HCC) incidence in chronic hepatitis B (CHB) patients, HCC can develop despite viral suppression. Identifying predictive biomarkers of HCC during NUC therapy remains clinically important. This study aimed to identify novel biomarkers by proteomic analysis of serum extracellular vesicle (EV) proteins in CHB patients receiving NUC therapy.</p><p><strong>Methods: </strong>We enrolled 242 CHB patients treated with NUCs for over one year, with serum HBV DNA < 3.0 log IU/mL, no prior HCC, and available stored serum samples. Proteomic analysis of serum EV proteins was carried out to identify candidate biomarkers, followed by validation of their serum levels using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The median age was 55 years; 144 were male. During a median follow-up of 10.1 years, 44 patients (18.2%) developed HCC. Five candidate EV proteins were identified: fibulin-3, VCAM-1, fibronectin, vWF, and FGFBP2. In univariate Cox analysis of serum levels of candidate EV proteins measured by ELISA, fibulin-3 and VCAM-1 were identified as significant predictive factors. In multivariate analysis, male sex, GGT, AFP, fibulin-3, and the FIB-4 index were independent predictors, whereas VCAM-1 was not. A cutoff value for fibulin-3 was set at 10.8 μg/mL. HCC incidence was significantly higher in patients with fibulin-3 ≥ 10.8 μg/mL and in those with ≥ 3 of five identified risk factors. The 10-year cumulative HCC incidence was 0% versus 37.2% in patients with 0 versus ≥ 3 risk factors.</p><p><strong>Conclusion: </strong>Serum fibulin-3 is a novel biomarker predictive of HCC in CHB patients undergoing NUC therapy.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Outcomes After Liver Resection for Barcelona Clinic Liver Cancer Stage B Hepatocellular Carcinoma Have Improved in the Contemporary Era.","authors":"Yoichi Yamamoto, Yoh Asahi, Shunsuke Shichi, Yuki Fujii, Yuzuru Sakamoto, Sunao Fujiyoshi, Ken Imaizumi, Takeshi Aiyama, Akihisa Nagatsu, Tatsuya Orimo, Tatsuhiko Kakisaka, Akinobu Taketomi","doi":"10.1111/hepr.70240","DOIUrl":"https://doi.org/10.1111/hepr.70240","url":null,"abstract":"<p><strong>Aim: </strong>The role of liver resection for Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) remains debated. Advances in imaging and multidisciplinary therapy have improved outcomes in contemporary practice, in our institution over time. We evaluated era-specific changes in survival after liver resection for BCLC-B HCC and shifts in postrecurrence management.</p><p><strong>Methods: </strong>This single-center retrospective cohort analyzed consecutive patients undergoing curative liver resection for BCLC-A and BCLC-B disease (n = 418 and 113) between 2005 and 2021. An exploratory minimum p-value approach based on 5-year overall survival (OS) in BCLC-B cases was used to determine a candidate cutoff for era stratification. Patients were divided into early and modern eras; survival outcomes were compared using propensity score matching.</p><p><strong>Results: </strong>The 5-year OS of BCLC-B patients improved from 44% before 2014 to 74% after 2015 (p < 0.05), whereas 5-year disease-free survival (DFS) increased from 5% to 22% (p < 0.05). Postrecurrence management shifted toward greater use of radiofrequency ablation/percutaneous ethanol injection therapy and systemic therapy with tyrosine kinase inhibitors or immune checkpoint inhibitors, with a relative decline in transarterial chemoembolization. In the contemporary era, 5-year OS of BCLC-B approximated that of BCLC-A (74% vs. 72%, p = 0.97), though DFS remained lower (22% vs. 45%, p < 0.05). Even after propensity score matching, the improvement in OS and DFS after 2015 remained significant (p < 0.05).</p><p><strong>Conclusions: </strong>Survival after liver resection for BCLC-B HCC has improved substantially in the modern era, achieving 5-year OS comparable to BCLC-A. Resection should be considered for appropriately selected BCLC-B patients within advanced multidisciplinary care.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to ‘Comment on “Effect of Direct-Acting Antivirals on Prognosis in Older Patients With Hepatitis C Virus-Related Hepatocellular Carcinoma After Curative Therapy: A Retrospective Study by the Red Cross Liver Study Group in Japan”’","authors":"Hironori Ochi,&nbsp;Masayuki Kurosaki","doi":"10.1111/hepr.70160","DOIUrl":"10.1111/hepr.70160","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 7","pages":"1177-1178"},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}