Journal of Hepatocellular Carcinoma最新文献

{"title":"Construction of a Nomogram Integrating Magnetic Resonance Imaging Features and Ephrin-A3 Expression to Predict Postoperative Overall Survival in Hepatocellular Carcinoma.","authors":"Yanyan Zhang, Lijuan Feng, Qianjuan Chen, Siyuan Tan, Wanyun Huang, Liling Long","doi":"10.2147/JHC.S632244","DOIUrl":"10.2147/JHC.S632244","url":null,"abstract":"<p><strong>Purpose: </strong>Elevated EFNA3 mRNA is associated with poor prognosis in hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic value of Ephrin-A3 immunohistochemical expression and construct a nomogram combining MRI features and Ephrin-A3 expression for postoperative OS prediction in HCC.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of 111 HCC patients, from whom MRI data were collected, and Ephrin-A3 immunohistochemistry was performed. Using an optimal cut-off value of averaged optical density (AOD) derived from Ephrin-A3 staining to predict OS, patients were categorized into high and low expression groups. The cohort was randomly split into training (70%) and validation (30%) sets. Univariate and multivariate Cox regression analyses identified independent OS predictors, and a nomogram was constructed to predict post-surgical OS. We assessed the model's performance through receiver operating characteristic (ROC) curves, area under the curve (AUC) measurements, Kaplan-Meier survival curves, calibration curves, and decision curve analysis (DCA) in both datasets.</p><p><strong>Results: </strong>Ephrin-A3 expression, tumor margin, nonrim arterial phase hyperenhancement, and extrahepatic metastasis were independent predictors of OS. The nomogram had concordance indexes of 0.76 and 0.72 in the training and validation sets, respectively. Time‑dependent ROC analysis showed AUCs of 0.790 and 0.776 at 36 and 60 months in the training set, and 0.737 and 0.770 in the validation set; the 12‑month AUC was not estimable due to zero events in the validation set. Kaplan-Meier curves showed significantly prolonged OS in the low-risk group across both datasets. Calibration curves showed good agreement between predicted and actual survival rates, and DCA supported the model's clinical utility.</p><p><strong>Conclusion: </strong>Ephrin-A3 serves as an independent prognostic factor for OS in HCC patients after surgery, and the constructed nomogram exhibits favorable predictive performance for postoperative survival.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"632244"},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge Mapping and Frontier Evolution of Traditional Medicine in Hepatocellular Carcinoma Research: A Bibliometric Analysis.","authors":"Ling Cai, Gang Wang, Tao Yang, Honglin Luo","doi":"10.2147/JHC.S624162","DOIUrl":"10.2147/JHC.S624162","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a common malignancy worldwide. Existing treatments are limited by high recurrence rates and drug resistance. Traditional medicine have the potential to be used to treat HCC because of their multi-target and low toxicity properties, however, there is no general review of the state of studies and tendencies. According to Web of Science Core Collection (WoSCC), this paper has analyzed 1936 English articles and reviews through bibliometric analysis of the data with CiteSpace and Bibliometrix, including publication trends, country/region distribution, the occurrence of keywords, collaboration networks, thematic evolution. The output of literature has been growing exponentially since 2020. The main contributor is China, which plays a central role in international cooperation. An important partner is the United States, and Egypt and France are possible partners. The area of interest is active ingredients, apoptosis modulation, and networking pharmacology. Network pharmacology and molecular docking are fundamental technologies. Emerging frontiers are tumor microenvironment, gut microbiota, lipid metabolism, and NF-κB signaling pathway. NF-κB activation, apoptosis, and angiogenesis regulation are new hotspots. This study systematically elucidates the research status and future directions of traditional medicine in the treatment of HCC, providing a reference for the prevention and treatment of HCC with traditional medicine. However, this study exclusively selected the WoSCC database for analysis, which may have the limitation of not comprehensively covering all research achievements relevant to this field.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"624162"},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulation of miRNA-2116-3p Predicts Prognosis of Hepatocellular Carcinoma and Regulates Tumor Cell Proliferation and Migration.","authors":"Qitian Sun, Changrong Ren, Ziyu Bai, Hui Liu, Shifan Shi, Jiahui Lu, Siming Wang, Wenjing Xuli, Qiyu Sun, Jian Li","doi":"10.2147/JHC.S628173","DOIUrl":"10.2147/JHC.S628173","url":null,"abstract":"<p><strong>Background and aims: </strong>The objective of this research was to investigate the diagnostic and prognostic value, as well as the functional roles of miR-2116-3p in HCC.</p><p><strong>Methods: </strong>We evaluated the expression level of miR-2116-3p using qRT-PCR. The diagnostic and prognostic implications of miR-2116-3p expression in plasma were investigated. A functional characterization of miR-2116-3p in HCC cells was carried out.</p><p><strong>Results: </strong>It was discovered that the expression of miR-2116-3p was notably reduced in both the plasma and tissue samples of HCC (P<0.05). The down-regulation of miR-2116-3p expression was correlated with the patients' tumor size and TNM stage (P<0.05). ROC curve analysis showed that plasma miR-2116-3p expression could effectively distinguish HCC patients (N=60) from control subjects, and this biomarker exhibited a moderate diagnostic performance for HCC. Based on the survival curves, patients with low miR-2116-3p levels exhibited poorer survival rates compared to those with high levels (log-rank P=0.006). Furthermore, the findings of the Cox analysis suggested that miR-2116-3p expression was an independent prognostic factor for HCC. The outcomes of cell experiments demonstrated that the overexpression of miR-2116-3p in HCC cells resulted in the inhibition of cell proliferation, migration, and invasion.</p><p><strong>Conclusions: </strong>The data from this study suggest that miR-2116-3p has the potential to serve as a novel biomarker for the diagnosis and prognosis of HCC. miR-2116-3p exerts a functional influence on cell proliferation, migration, and invasion.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"628173"},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology Dependent Differences in Immunotherapy Response and Prognosis Between MASH-HCC and HBV-HCC.","authors":"Feixiang Xiong, Xuejie Zhang, Dandan Chen, Yang Zhou, Peipei Meng, Fengna Yan, Yixin Hou","doi":"10.2147/JHC.S620276","DOIUrl":"https://doi.org/10.2147/JHC.S620276","url":null,"abstract":"<p><strong>Background: </strong>The incidence of metabolic dysfunction-associated steatohepatitis related hepatocellular carcinoma is increasing. However, its response to immunotherapy remains unclear. This study aimed to compare the prognosis of patients with MASH-HCC and hepatitis B virus-related HCC (HBV-HCC) under different treatment strategies.</p><p><strong>Methods: </strong>This single-center retrospective study included 218 patients with HCC from 2022 to 2025. The primary endpoint was progression-free survival (PFS), and the secondary endpoint was 1-year overall survival (OS). Kaplan-Meier analysis, Cox regression models, and restricted cubic spline (RCS) analysis were used to evaluate the association between immune cells and prognosis. Stratified and subgroup analyses were also performed.</p><p><strong>Results: </strong>A total of 136 HBV-HCC and 82 MASH-HCC patients were enrolled in this study. PFS was significantly longer in HBV-HCC patients than in MASH-HCC patients (70.59% vs 41.46%, <i>P</i><0.001, HR=3.426, 95% CI: 1.668-7.038), while no significant difference in OS was observed (P=0.302). Cox regression indicated that multiple therapeutic modalities were associated with PFS in both subgroups. After stratification by treatment, PFS differences remained prominent in selected interventions. RCS analysis revealed a significant association between CD4⁺ T cell count and PFS (<i>P</i> overall=0.036). Stratification by CD4⁺ T-cell cutoff (354 cells/μL) showed that the prognostic gap between etiologies was diminished in patients with higher CD4⁺ T cell levels, while lower CD4⁺ T cell counts were associated with poorer PFS in MASH-HCC.</p><p><strong>Conclusion: </strong>MASH-HCC patients showed a trend toward poorer response to ICI therapy compared with HBV-HCC patients, particularly in those with CD4⁺ T cell counts <354 cells/μL. These results suggest that both disease etiology and immune status may contribute to variability in immunotherapy outcomes and warrant consideration in treatment decision making.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"620276"},"PeriodicalIF":3.9,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuing Immune Checkpoint Inhibitor-Based Therapy After Complete Response in Unresectable Hepatocellular Carcinoma: Evidence, Bias, and a Research Framework.","authors":"Yujia He, Zhe Wang","doi":"10.2147/JHC.S645986","DOIUrl":"https://doi.org/10.2147/JHC.S645986","url":null,"abstract":"<p><p>Immune checkpoint inhibitor (ICI)-based regimens can induce radiographic complete response (CR) in a small but clinically important subset of patients with unresectable hepatocellular carcinoma (HCC). Whether treatment can then be stopped safely remains unresolved. Evidence comes predominantly from retrospective cohorts and post hoc analyses: selected complete responders have durable disease control after cessation, but neither patient-selection criteria nor an optimal post-CR treatment duration has been validated. This structured critical narrative review distinguishes direct evidence in HCC complete responders from indirect HCC studies, local-treatment-assisted CR, and evidence from other tumors. Interpretation depends on the response criterion, confirmation of CR, reason for stopping, residual treatment exposure, and the alignment of treatment assignment with follow-up. Chronic liver disease adds competing mortality and can reduce the opportunity for salvage independently of tumor recurrence. We integrate these issues into a clinical assessment pathway and a framework for prospective research, with attention to recurrence phenotype, hepatic reserve, toxicity, treatment burden, and treatment-free outcomes. Priorities include reproducible CR definitions, longitudinal registries, comparisons of prespecified treatment strategies, and prospective evaluation of surveillance and salvage. Current evidence supports individualized discussion of cessation rather than its routine use after CR or a fixed treatment duration.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"645986"},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential Multimodal Therapy for Conversion Resection of Stage IIIa Hepatocellular Carcinoma: A Case Report.","authors":"Yanxin Li, Ji Luo, Jinping Yang, Jianyong Zhang, Minqiang Sun, Shimin Zhang","doi":"10.2147/JHC.S645932","DOIUrl":"https://doi.org/10.2147/JHC.S645932","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility and clinical value of conversion resection after sequential comprehensive therapy consisting of transarterial chemoembolization (TACE), targeted therapy, immunotherapy and radiotherapy in patients with initially advanced stage IIIa hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>The clinical data of a 61-year-old male patient with massive stage IIIa HCC accompanied by right portal vein tumor thrombus were retrospectively analyzed. The maximum diameter of the primary tumor was approximately 10.0 cm at initial diagnosis. The patient received sequential combination therapy of TACE plus targeted-immunotherapy for 8 months, followed by liver tumor radiotherapy about 1 month and maintenance targeted-immunotherapy for 12 months. After sustained tumor shrinkage, radical resection was performed on March 13, 2026.</p><p><strong>Results: </strong>Following sequential multimodal treatment, the maximum tumor diameter decreased from 10.0 cm to 4.0 cm × 3.6 cm, achieving partial response (PR). The tumor was successfully downstaged to resectable status, and the patient recovered smoothly postoperatively without severe complications.</p><p><strong>Conclusion: </strong>Sequential comprehensive therapy combining TACE, targeted-immunotherapy and radiotherapy can significantly downstage initially advanced stage IIIa HCC, create opportunities for curative resection, and potentially improve long-term prognosis of patients.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"645932"},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Outcomes in Patients with Advanced Hepatocellular Carcinoma Based on Pretreatment Serum Lactate Dehydrogenase Level and Albumin-Bilirubin Grade: A Single-Center, Retrospective, Non-Randomized Cohort Study.","authors":"Rong Yu, Huaxi Fan, Guishu Wu, Jing Zhang, Xiaolong Liu, Xiangyu Deng, Mingyue Rao, Jianwen Zhang","doi":"10.2147/JHC.S634409","DOIUrl":"https://doi.org/10.2147/JHC.S634409","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a major global contributor to cancer mortality. The primary objective of this study was to compare the prognostic value of pretreatment albumin-bilirubin (ALBI) grade and serum lactate dehydrogenase (LDH) levels in patients with advanced hepatocellular carcinoma receiving first-line triple therapy consisting of immune checkpoint inhibitors (ICI), targeted agents, and radiotherapy.</p><p><strong>Methods: </strong>This single-center retrospective cohort study enrolled 143 unresectable advanced HCC patients treated with ICI-targeted combined radiotherapy from 2019 to 2023. Patients were stratified by baseline ALBI grade (1 vs 2) and LDH levels (LDH-0: ≤ 250 U/L vs LDH-1: > 250 U/L). Treatment response was evaluated per mRECIST 1.1, and adverse events (AEs) were graded by NCI-CTCAE v4.0. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and safety profiles. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the standalone predictive performance of ALBI grade and LDH status for OS and PFS endpoints.</p><p><strong>Results: </strong>ALBI-1 and LDH-0 patients obtained significantly higher ORR and DCR than ALBI-2 and LDH-1 patients (P < 0.05 and P < 0.001, respectively). No efficacy gaps existed between favorable-risk subgroups (ALBI-1 vs LDH-0) or poor-risk subgroups (ALBI-2 vs LDH-1). The cohort's median OS and PFS were 15.7 and 12.8 months. Univariate analysis showed ALBI-1 was associated with lowered risks of death (Hazard ratio (HR) = 0.27, P < 0.001) and progression (HR = 0.38, P < 0.001), although this association was not statistically significant in multivariate Cox models, while LDH-0 reduced mortality (HR = 0.33, P < 0.001) and progression risks (HR = 0.53, P = 0.007). ALBI-1 and LDH-0 had comparable survival, and LDH-1 patients showed numerically better survival than ALBI-2 patients. ROC curves showed weak predictive ability for single ALBI or LDH (all areas under the curves near 0.5). ALBI-2 patients suffered more grade 1-4 AEs, whereas LDH subgroups showed no consistent toxicity differences.</p><p><strong>Conclusions: </strong>Pretreatment ALBI grade and LDH showed comparable prognostic stratification performance for advanced HCC receiving triple therapy, while ALBI grade better predicts treatment-related toxicities. Single markers had limited predictive efficacy, and combined ALBI-LDH scoring may improve clinical risk stratification, although its added clinical value requires prospective external validation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"634409"},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Inflammatory-Nutritional Markers Refine Machine-Learning Prognostic Stratification for Resectable Hepatocellular Carcinoma.","authors":"Ao Sun, Changlei Li, Junzhe Zhang, Guangyi Yu, Zhen Jia, Haiyang Wang, Haowen Liu, Kun Li, Bin Tan, Jingyu Cao, Chao Qu","doi":"10.2147/JHC.S637624","DOIUrl":"https://doi.org/10.2147/JHC.S637624","url":null,"abstract":"<p><strong>Background: </strong>Outcomes after curative resection for hepatocellular carcinoma (HCC) remain heterogeneous, and conventional staging systems have limited resolution for individual postoperative risk prediction. Serum inflammatory-nutritional markers are inexpensive and routinely available, but their value as integrated inputs for machine-learning survival modeling after HCC resection remains insufficiently defined.</p><p><strong>Methods: </strong>This retrospective cohort study included 880 patients with pathologically confirmed HCC who underwent curative resection at the Affiliated Hospital of Qingdao University between 2013 and 2024. Overall survival (OS) was the primary endpoint, and recurrence-free survival (RFS) was secondary. Twelve preoperative serum inflammatory-nutritional indexes were assessed after adjustment for key clinical covariates. Retained markers were combined into a serum inflammatory-nutritional risk score (SINRS). LASSO regression and Boruta algorithm were then used to identify clinicopathological predictors. The SINRS and selected variables were entered into 10 machine learning algorithms and their 101 combinations. Model performance was evaluated using C-index, time-dependent AUC, calibration, decision curve analysis, Kaplan-Meier curve and SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>Neutrophil percentage-to-albumin ratio (NPAR), prognostic nutritional index (PNI), albumin-to-alkaline phosphatase ratio (AAPR), fibrinogen-to-albumin ratio (FAR) and hemoglobin-albumin-lymphocyte-platelet (HALP) score, were retained for SINRS construction. Nine clinicopathological predictors were selected: age, alpha-fetoprotein, alkaline phosphatase, eosinophil count, lymphocyte count, fibrinogen, tumor size, microvascular invasion and satellite nodules. Among all candidate strategies, the random survival forest (RSF) model showed the best predictive performance. For OS prediction, 2-, 3- and 5-year AUCs were 0.814, 0.792 and 0.816 in the training cohort and 0.796, 0.787 and 0.790 in the validation cohort. SHAP analysis ranked microvascular invasion, SINRS and tumor size among the features with the highest model-derived importance for OS prediction.</p><p><strong>Conclusion: </strong>A serum inflammatory-nutritional marker-informed RSF model refined OS stratification after curative HCC resection in this internally validated cohort, which may provide additional information for postoperative risk stratification but requires external validation before clinical implementation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"637624"},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Hepatocellular Carcinoma Complicated by Severe Portal Hypertension Secondary to an Arterioportal Shunt: A Case Report.","authors":"Hiroshi Shintani, Satoshi Wakama, Shota Ueda, Shunsuke Ogata, Hironori Tanaka, Katsuji Tokuhara, Naoki Kataoka, Tetsuo Sonomura","doi":"10.2147/JHC.S642701","DOIUrl":"https://doi.org/10.2147/JHC.S642701","url":null,"abstract":"<p><strong>Introduction: </strong>Arterioportal (AP) shunts are a recognized vascular complication of hepatocellular carcinoma (HCC). Severe AP shunts can cause portal hypertension, which can lead to complications such as variceal bleeding and refractory ascites. However, optimal management of HCC complicated by severe AP shunts remains challenging, particularly in patients with advanced disease.</p><p><strong>Case presentation: </strong>A 73-year-old woman presented with melena and massive hematemesis due to esophageal varices. Contrast-enhanced computed tomography revealed multifocal HCC confined to the right hepatic lobe, Vp3 portal vein tumor thrombosis, and a high-flow AP shunt with hepatofugal portal flow. Despite treatment with diuretics, progressive portal hypertension resulted in rapidly worsening refractory ascites. Although the disease corresponded to Barcelona Clinic Liver Cancer stage C, hepatic functional reserve was relatively preserved, with no extrahepatic metastases having been identified. Angiography revealed a severe AP shunt with persistent opacification of the portal venous system even under balloon-assisted angiography, suggesting exceptionally high shunt flow. Given that the severe portal hypertension was primarily attributed to the AP shunt, right hepatectomy was performed with the dual aim of curative tumor resection and AP shunt elimination. Histopathological examination revealed HCC with portal vein tumor thrombosis and a vessel-encapsulating tumor cluster pattern. Postoperatively, portal venous flow normalized, refractory ascites resolved completely, and tumor marker levels markedly decreased.</p><p><strong>Conclusion: </strong>In carefully selected patients with HCC complicated by a severe AP shunt, hepatectomy may represent a potential treatment option for simultaneously achieving tumor control and alleviating AP shunt-related portal hypertension. Treatment decisions should consider hemodynamic abnormalities in addition to conventional tumor staging and require careful multidisciplinary evaluation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"642701"},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Model Integrating Conventional Ultrasound Radiomics and Clinicopathological Features for Early Recurrence Risk Prediction After Curative-Intent Hepatectomy in Hepatocellular Carcinoma.","authors":"Xinyue Zhao, Bolin Wu, Yichi Chen, Wen Cheng","doi":"10.2147/JHC.S647092","DOIUrl":"https://doi.org/10.2147/JHC.S647092","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and compare machine learning models integrating conventional ultrasound radiomic features with clinicopathological variables for predicting one-year postoperative recurrence in patients with hepatocellular carcinoma after curative-intent hepatectomy.</p><p><strong>Methods: </strong>This retrospective, single-center study included 154 patients with pathologically confirmed hepatocellular carcinoma who underwent curative-intent hepatectomy between January 2020 and December 2024. Patients were divided into a training cohort (n = 124) and a validation cohort (n = 30). Clinicopathological data and preoperative conventional ultrasound images were collected. Radiomic features were extracted and selected using least absolute shrinkage and selection operator (LASSO) regression. Predictive models were developed and compared using conventional logistic regression and four machine learning algorithms, including a generalized linear model (GLM), random forest (RF), support vector machine (SVM), and gradient boosting machine (GBM), based on different combinations of clinicopathological variables and radiomic features. Model performance was evaluated in the validation cohort.</p><p><strong>Results: </strong>Multivariable logistic regression identified Edmondson grade, satellite nodules, fibrinogen, and white blood cell count as factors independently associated with postoperative recurrence. Among the evaluated models, the RF model combining clinicopathological factors with the Radscore achieved the highest numerical validation area under the receiver operating characteristic curve (AUC) of 0.717 (95% confidence interval: 0.523-0.910), with an accuracy of 70.0%, a sensitivity of 42.9%, and a specificity of 93.8%.</p><p><strong>Conclusion: </strong>The RF model integrating clinicopathological factors with the Radscore showed moderate discrimination for one-year postoperative recurrence and may hold promise for postoperative risk assessment. Given the limited validation sample size and uncertainty in model performance, these findings should be considered exploratory and require further validation in larger, independent, multicenter cohorts before clinical implementation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"647092"},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}