Journal of Hepatocellular Carcinoma最新文献

{"title":"Intratumoral Fibrosis is a Potential Biomarker in Patients with Hepatocellular Carcinoma Undergoing Liver Resection.","authors":"Qi-Yuan Deng, Tian-Cheng Wang, Kun Ye","doi":"10.2147/JHC.S608858","DOIUrl":"10.2147/JHC.S608858","url":null,"abstract":"<p><strong>Background: </strong>Intratumoral fibrosis (ITF) has been demonstrated to influence the prognosis of various fibrotic solid tumors. Thus, this study aimed to validate its role as a potential prognostic biomarker in patients with hepatocellular carcinoma (HCC) undergoing liver resection.</p><p><strong>Methods: </strong>This investigation enrolled 367 adult patients diagnosed with HCC who underwent liver resection. The patients were classified into high- (score ≥ 2) and low-ITF (score < 2) groups based on a semiquantitative Sirius red staining scale (0-3). IHC staining for CD34 was performed on resected samples to determine microvascular density (MVD) and to investigate the association between ITF and tumor vascularization. Cox proportional hazards regression with backward stepwise selection was employed to identify independent predictors for early HCC recurrence. Moreover, to mitigate the impact of confounding factors, propensity score matching (PSM) was conducted between patients in the high- and low-ITF groups. Lastly, the Kaplan-Meier method was utilized to assess and compare the disease-free survival (DFS) and overall survival (OS) between the two cohorts.</p><p><strong>Results: </strong>The study categorized patients into high-ITF and low-ITF groups. Backward stepwise Cox regression analysis revealed that liver cirrhosis (P<0.001), serum monocyte count (P<0.001), AFP >200 ng/mL (P<0.001), substantial intratumoral necrosis (P<0.001), presence of intratumoral artery (P<0.001), nodule-in-nodule architecture (P<0.001), and high-ITF (P<0.001) were significantly associated with early HCC recurrence. Furthermore, the results suggested that DFS and OS were significantly shorter in the high-ITF group compared to the low-ITF group, both before and after PSM (P<0.05). Finally, compared to low-ITF HCCs, high-ITF HCCs were more frequently associated with high MVD counts (54.0, IQR: 43.0-67.5 vs. 45.0, IQR: 30.0-58.0, P<0.001).</p><p><strong>Conclusion: </strong>ITF holds promise as a prognostic biomarker for early recurrence and prognosis in patients with HCC who underwent liver resection, with practical applicability for developing personalized treatment strategies for HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"608858"},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308495","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":"A Machine Learning Guided System for Therapeutic Decision-Making in Intra-Arterial Therapy of Hepatocellular Carcinoma.","authors":"Linling Tan, Rongshan Fan, Jun Zhang, Hongmei Fan, Shenglan Wu, Wang Li","doi":"10.2147/JHC.S613199","DOIUrl":"10.2147/JHC.S613199","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a machine learning-guided system (MLGS) for stratifying prognostic risk of unresectable hepatocellular carcinoma (uHCC) based on clinical data before and after intra-arterial therapy (IAT).</p><p><strong>Methods: </strong>Between April 2008 and June 2022, a total of 5646 eligible patients with uHCC who underwent initial IAT were consecutively identified in 15 hospitals. The 5 year mortality was used as primary predictive outcome. Thirty-five sets of clinical data, including 29 preoperative and 6 postoperative data, were input successively into five supervised ML models. The performance of the ML models was compared using the area under the receiver operating characteristic (AUC) curve with the DeLong test. Kaplan-Meier analysis was used to revealed overall survival (OS) risk stratification of the MLGS.</p><p><strong>Results: </strong>These patients were divided into training datasets (TD, n=3387), internal testing datasets (ITD, n=1130), and external test datasets (ETD, n=1129), respectively.The CatBoost model yield the best discrimination using preoperative data in the ML models using 23 variables, the AUC of CatBoost model were 0.777-0.735 in three datasets. Meanwhile, the XGBoost model yield the best discrimination using postoperative 20 variables and the AUC of XGBoost model were 0.904-0.861 in three datasets, which outperform significantly the performance of the CatBoost model (DeLong test, <i>P</i> < 0.001). The MLGS based on the XGBoost model provide significantly different OS between three risk stratification in three datasets (all, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The MLGS may guide radiologists in developing strategies of IAT for uHCC. Prospective studies are needed to evaluate its clinical utility.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"613199"},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308506","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":"TACE Combined with Ralox-HAIC (Oxaliplatin Puls Raltitrexed) and System Therapy in Patients with Unresectable Hepatocellular Carcinoma.","authors":"Ruiqing Liu, Guangshao Cao, Lupeng Li, Jianwen Liu, Huicun Cao, Mengyan Xing, Yangbo Feng, Zesheng Li, Boyu Wang","doi":"10.2147/JHC.S609273","DOIUrl":"10.2147/JHC.S609273","url":null,"abstract":"<p><strong>Objective: </strong>To retrospective analysis the efficacy and safety of Transarterial Chemoembolization (TACE) combined with Hepatic Arterial Infusion Chemotherapy (Ralox-HAIC, Oxaliplatin + Raltitrexed) and systemic therapy in patients with unresectable Hepatocellular Carcinoma (uHCC).</p><p><strong>Methods: </strong>Clinical data of patients with uHCC who received TACE combined with Ralox-HAIC followed by sequential systemic therapy at our hospital between January 2023 and December 2024 were analyzed. The primary endpoint was Objective Response Rate (ORR). Secondary endpoints included Progression-Free Survival (PFS), Overall Survival (OS) and treatment safety.</p><p><strong>Results: </strong>A total of thirty-six patients with complete data were included. Efficacy evaluation showed: Complete Response (CR) in 6 cases (16.67%), Partial Response (PR) in 22 cases (61.11%), Stable Disease (SD) in 5 cases (13.89%), and Progressive Disease (PD) in 2 cases (5.56%). The ORR was 77.78%, and the Disease Control Rate (DCR) was 91.67%. The median PFS was 12.0 months, and the median OS was 19.0months. The one-year and two-year survival rates were 89% and 38%, respectively. No Grade 4 treatment-related adverse events or treatment-related deaths occurred.</p><p><strong>Conclusion: </strong>TACE combined with Ralox-HAIC and systemic therapy demonstrated a high ORR and DCR with manageable safety in uHCC, warranting further prospective studies for validation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"609273"},"PeriodicalIF":3.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308521","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":"Near-Infrared Fluorescent Probes Targeting LAG-3 for Guiding Immunomodulation and Efficacy Monitoring of Stereotactic Body Radiotherapy in Liver Cancer.","authors":"Qingyun Lu, Peng Zeng, Yanli An, Yingyu Qin, Jing Zhang, Muhao Xu, Cheng Wang, Ming Wu, Rong Chen","doi":"10.2147/JHC.S584426","DOIUrl":"10.2147/JHC.S584426","url":null,"abstract":"<p><strong>Purpose: </strong>Lymphocyte activation gene 3 (LAG-3) is an attractive biomarker for immunotherapy in hepatocellular carcinoma (HCC) due to its high expression. Based on our previously identified LAG-3 peptide, we developed a LAG-3 targeted peptide probe named Cqy-12-Cy5 for monitoring the dynamic regulation of LAG-3 by stereotactic body radiotherapy (SBRT), thereby providing a strategy to enhance the immunotherapeutic efficacy for HCC.</p><p><strong>Methods: </strong>Immunohistochemistry (IHC) was used to detect the expression of LAG-3 in HCC tissues and its correlation with clinicopathological characteristics. An optical fluorescent probe (Cqy-12-Cy5) was constructed, and its in vivo targeting ability and metabolic profile were evaluated via near-infrared fluorescent (NIRF). Flow cytometry (FCM) was employed to assess the apoptosis of H22 cells after radiation, aiming to screen the optimal radiation dose. Furthermore, the regulatory effect of SBRT on LAG-3 expression in HCC was detected, along with changes in the proportion of CD8⁺ T cells, TNF-α and IFN-γ following SBRT. Dynamic observations of tumor growth and LAG-3-targeted fluorescent expression after SBRT were performed using magnetic resonance imaging (MRI) and NIRF.</p><p><strong>Results: </strong>LAG-3 is highly expressed in HCC and is closely related to tumor progression. The fluorescent uptake of the Cqy-12-Cy5 in the tumor region reached a peak at 1 hour after tail vein injection. A radiation dose of 6 Gy was identified as the optimal dose. SBRT could reduce the size of the tumor, promote CD8⁺ T cell infiltration and increase the secretion of TNF-α and IFN-γ.</p><p><strong>Conclusion: </strong>The successfully constructed LAG-3-targeting NIRF probe enables non-invasive, real-time monitoring of tumor growth and LAG-3 expression. SBRT can inhibit tumor growth, modulate LAG-3 expression, promote T cell infiltration and cytokine secretion in HCC. The Cqy-12-Cy5 can dynamically monitor the modulation of LAG-3 by SBRT, providing a strategy for guiding the timing of combination therapy and promoting synergistic immunotherapeutic efficacy.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"584426"},"PeriodicalIF":3.9,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301903","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":"Tumor-Associated Macrophages in Hepatocellular Carcinoma: From Ontogeny and Heterogeneity to Immune Evasion and Therapeutic Targeting.","authors":"Yuhao Su, Yuxin Liang, Deyuan Zhong, Yahui Chen, Shuo Shuo Ma, Xiaolun Huang","doi":"10.2147/JHC.S616101","DOIUrl":"10.2147/JHC.S616101","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer morbidity and mortality worldwide and typically arises within a profoundly immunosuppressive tumor microenvironment (TME). Among the myeloid populations that infiltrate the HCC microenvironment, tumor-associated macrophages (TAMs) are numerically dominant and function as central orchestrators of tumor initiation, progression, and immune evasion. TAMs originate from both tissue-resident Kupffer cells and bone marrow-derived monocytes, and are shaped by TME-derived cues such as hypoxia, metabolic stress, and inflammatory mediators that polarize them toward a tumor-promoting, M2-like phenotype. Once activated, TAMs release pro-angiogenic and trophic factors that sustain vascular remodeling and tumor proliferation, and they induce epithelial-mesenchymal transition (EMT) and stemness-associated programs that facilitate invasion and metastasis. Concomitantly, TAMs suppress antitumor immunity through the secretion of immunosuppressive cytokines such as IL-10 and TGF-β, the expression of PD-L1, and the recruitment of regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Clinically, a high density of TAM infiltration is strongly associated with aggressive disease features, early recurrence, and poor prognosis. Given their dual roles in promoting immune escape and therapeutic resistance, TAMs have emerged as critical nodes within the HCC ecosystem and as promising targets for translational intervention. This review summarizes current understanding of TAM ontogeny, phenotypic diversity, and functional heterogeneity in HCC, delineates the molecular and immunological mechanisms through which they drive tumor progression, and discusses emerging TAM-targeted therapeutic strategies with clinical potential including CSF1R inhibition, CD47-SIRPα blockade, and chimeric antigen receptor-macrophage (CAR-M) therapies.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"616101"},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295336","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":"Prognostic Value of the SEA Score in Double-Negative DCP/AFP Unresectable HCC with Triple Therapy.","authors":"Hesheng Lin, Fulin Ran, Jiayi Wu, Chaoyue Huang, Junyi Wu, Chengyuan Liu, Xueyao Wang, Houxiang Ya, Kaiwen Jiang, Jing Gu, Maolin Yan, Shuqun Li","doi":"10.2147/JHC.S606282","DOIUrl":"10.2147/JHC.S606282","url":null,"abstract":"<p><strong>Background & aims: </strong>The combination of transarterial chemoembolization (TACE), lenvatinib and PD-1 inhibitors (triple therapy) demonstrates encouraging efficacy in patients with unresectable hepatocellular carcinoma (uHCC). But its prognostic value remains unclear in patients with double negative des gamma carboxy prothrombin (DCP) and alpha fetoprotein (AFP) uHCC. To identify the best candidates for this treatment, this study aimed to evaluate the prognosis of this specific population and to establish a practical prognostic scoring model.</p><p><strong>Methods: </strong>This multicenter retrospective study included 136 patients with double-negative DCP/AFP uHCC receiving triple therapy, stratified into training (n=91) and validation (n=45) cohorts. Independent predictors for overall survival (OS) were identified by Cox regression to build a scoring system. The model's performance was validated using Kaplan-Meier curves and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>In the training cohort, median OS was not reached, and median progression-free survival was 18.9 months. Additionally, triple therapy produced a 79.1% objective response rate and a 95.6% disease control rate. Four variables (maximal tumor size ≥ 5 cm, absence of conversion surgery, presence of extrahepatic metastasis, and age < 55 years), were independent risk factors for prognosis and were utilized to develop the SEA score. The SEA score effectively stratified patients into low risk (0-3 points) and high risk (4-6 points) groups, with significantly different survival outcomes in both cohorts. This model showed robust discriminative performance, with AUCs of 0.80 in the training cohort and 0.68 in the validation cohort, and outperformed all individual prognostic factors.</p><p><strong>Conclusion: </strong>Triple therapy demonstrates promising efficacy and an acceptable safety profile in patients with double-negative DCP/AFP uHCC. The SEA score effectively stratifies patient outcomes, facilitating the identification of optimal candidates for triple therapy, though prospective validation is warranted before widespread clinical use.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"606282"},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301912","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":"Development and Validation of a Machine Learning-Based Individualized Model to Predict TKI Benefit in Postoperative Recurrent HCC.","authors":"Meng Li, Yumin Jiang, Lin Gong, Ruitao Sun, Aoyun Hao, Kun Liu, Kunye Luan, Zheng Jia, Shimei Zhang, Kui Liu, Bin Tan, Weiyu Hu, Chao Qu, Jingyu Cao","doi":"10.2147/JHC.S599142","DOIUrl":"10.2147/JHC.S599142","url":null,"abstract":"<p><strong>Background: </strong>Postoperative recurrence is a major contributor to poor prognosis in hepatocellular carcinoma (HCC) after curative resection. Tyrosine kinase inhibitors (TKIs) are commonly used for recurrent HCC, yet substantial interpatient heterogeneity limits their universal benefit, and reliable tools to individualize post-recurrence therapy are lacking.</p><p><strong>Methods: </strong>We retrospectively analyzed 454 patients with recurrent HCC following curative resection. Overlap weighting based on propensity scores was applied to balance baseline characteristics between TKI-treated and non-TKI-treated groups and to assess the survival benefit of TKI therapy. Machine learning-based survival models were independently developed for each treatment cohort using multiple algorithms and internally validated. A counterfactual inference framework was implemented to estimate individualized survival outcomes under alternative treatment strategies and to identify the optimal therapy for each patient.</p><p><strong>Results: </strong>After overlap weighting, TKI therapy was associated with improved survival compared with non-TKI treatment, including longer recurrence-free survival (median, 24 vs. 12 months; HR = 0.355, <i><b>P</b></i> < 0.001) and overall survival (median, 36 vs. 18 months; HR = 0.486, <i><b>P</b></i> = 0.001). In the non-TKI cohort, an eight-feature survival support vector machine (Surv-SVM) model achieved strong predictive performance (C-index: 0.796 in training, 0.766 in validation). In the TKI cohort, a four-feature random survival forest (RSF) model showed the highest discrimination (C-index: 0.856 and 0.838). Both models demonstrated good calibration and stable time-dependent performance. Counterfactual analysis revealed potential treatment mismatch in 23.4% of patients, including 20.7% who received non-TKI therapy but were predicted to benefit more from TKI treatment.</p><p><strong>Conclusion: </strong>TKI therapy provides significant survival benefit in recurrent HCC after curative resection. Our machine learning-based, counterfactual framework enables individualized estimation of treatment benefit, supporting personalized post-recurrence therapy and facilitating precision management in this high-risk population.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"599142"},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295351","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":"A Novel Predictive Model Based on Glutathione Metabolism Genes RRM2 and G6PD in Hepatocellular Carcinoma.","authors":"Xiaolong Li, Jiayan Tang, Huotang Qin, Yu Huang, Minqing Li, Zaiyong Yang, Jiali Meng, Ling Li","doi":"10.2147/JHC.S529380","DOIUrl":"10.2147/JHC.S529380","url":null,"abstract":"<p><strong>Purpose: </strong>Glutathione (GSH) metabolism is closely associated with tumor behavior in hepatocellular carcinoma (HCC). HCC is the third fatality reason and the sixth incidence rank in global tumor ranking. Our study explored the connection between glutathione metabolism genes (GMGs) expression and HCC progression and prognosis.</p><p><strong>Methods: </strong>We obtained seven differentially expressed genes (DEGs) by analyzing GMGs dataset in HCC and the TCGA-LIHC cohort. Utilizing LASSO Cox analysis, we developed a predictive model based on 2-GMGs: Ribonucleotide reductase regulatory subunit M2 (RRM2) and glucose-6-phosphate dehydrogenase (G6PD). The model was apprized with the SHapley Additive exPlanations (SHAP). The predictive ability of the model was rigorously validated through prognostic stratification, univariable and multivariable Cox regression, and nomogram construction. We anticipated chemotherapy sensitivity using the GDSC database and used GEPIA and TIMER to examine the correlations with 2-GMGs expression and cellular immune-associated markers. This study also detects the impact of RRM2 and G6PD expression on HCC patient survival through immunohistochemistry.</p><p><strong>Results: </strong>A prognostic model and nomogram composed of 2-GMGs provided an accurate prognostic for HCC patients. The median risk score as a dividing criterion was used to classify into low and high-risk groups. A positive outcome for the lowest-risk group was achieved by Kaplan-Meier curves. Moreover, the risk score was verified as an independable predictive indicator by multifactorial and unifactorial Cox regression analyses. Notable disparities between the two groups regarding the infiltration of different immune cell subtypes, tumor mutation burden (TMB) and sensitivity to chemotherapeutic subtypes were observed. Finally, immunohistochemical indicated that increased RRM2 and G6PD expression and decreased viability of HCC patients.</p><p><strong>Conclusion: </strong>Our findings exposit that the higher 2-GMGs expression and the worse progression and prognosis of HCC. The SHAP approach was employed to elucidate the 2-GMGs model, enhancing its utility for clinicians.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"529380"},"PeriodicalIF":3.9,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295314","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":"Comparative Performance of Stereotactic Body Radiotherapy and Lenvatinib in Unresectable Hepatocellular Carcinoma Complicated by Portal Vein Tumor Thrombosis: A Propensity Score-Matched Cohort Analysis.","authors":"Jian Huang, Fu-Chen Liu, Yun Yang, Sheng-Xian Yuan, Fang-Ming Gu, Bei-Ge Jiang, Ze-Ya Pan","doi":"10.2147/JHC.S589137","DOIUrl":"10.2147/JHC.S589137","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether adding stereotactic body radiotherapy (SBRT) to lenvatinib improves outcomes for patients with unresectable hepatocellular carcinoma (uHCC) and portal vein tumor thrombosis (PVTT).</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 133 cases of uHCC with PVTT treated with either lenvatinib plus SBRT (n = 65) or lenvatinib alone (n = 68) between 2021 and 2023. To minimize baseline imbalances, 1:1 propensity score matching (PSM, caliper width, 0.02) was performed. The primary endpoints were overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>Across the full study population, patients receiving lenvatinib in combination with SBRT experienced significantly longer median OS relative to those who received lenvatinib alone (24.7 vs 16.4 months; HR=0.521, 95% CI: 0.338-0.802, p = 0.003). A similar advantage was observed for PFS (13.0 vs 8.6 months; HR=0.494, 95% CI: 0.335-0.728, p < 0.0001). These findings remained consistent after PSM, with hazard ratios of 0.589 for OS and 0.540 for PFS. The objective response rate was also substantially higher in the combination arm than in the monotherapy arm (55.4% vs 30.9%, p = 0.004). Subgroup analyses revealed that the survival advantage was confined to patients with Cheng's type I-II PVTT, whereas no significant benefit was observed in those with type III-IV disease. Furthermore, salvage hepatectomy was an independent protective factor for survival in 33 cases (24.8%), with a significantly higher conversion rate in the combined treatment group (30.8%). Both treatment groups had comparable and manageable safety profiles.</p><p><strong>Conclusion: </strong>Lenvatinib in combination with SBRT confers meaningful advantages in both survival and tumor response over lenvatinib monotherapy in individuals with uHCC and PVTT, particularly among those with Cheng's type I-II involvement. Moreover, this multimodal approach appears to be an effective strategy for achieving tumor downstaging and enabling subsequent salvage hepatectomy.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"589137"},"PeriodicalIF":3.9,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295338","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":"Subgroup-Specific Nomogram for Refined Risk Stratification in Hepatocellular Carcinoma Patients with Low LDL-C.","authors":"Bojun Liu, Zhixia Gu, Ling Li, Lei Li, Ronghua Jin, Caixia Hu","doi":"10.2147/JHC.S616354","DOIUrl":"10.2147/JHC.S616354","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) exhibits high mortality and clinical heterogeneity. While low low-density lipoprotein cholesterol (LDL-C) is a recognized risk factor for HCC, its continuous dose-response relationship with overall survival (OS) remains unclear. Furthermore, existing prognostic models lack precision for this specific high-risk population, highlighting an urgent need for individualized risk stratification.</p><p><strong>Methods: </strong>A retrospective cohort of 486 HCC patients treated at Beijing You'an Hospital (January 1, 2015-January 1, 2021) was analyzed. Restricted cubic splines (RCS) and Cox regression evaluated the LDL-C and OS dose-response relationship. Following quartile stratification (Q1-Q4), the cohort was dichotomized into low (Q1+Q2, n=245) and high (Q3+Q4, n=241) LDL-C groups. Within the high-risk low LDL-C subgroup, least absolute shrinkage and selection operator (LASSO) regression identified core features to construct a specific nomogram, validated via concordance index (C-index), receiver operating characteristic (ROC) curves, calibration, decision curve analysis (DCA), and Kaplan-Meier (KM) curves for risk stratification.</p><p><strong>Results: </strong>RCS analysis revealed a non-linear relationship: mortality risk increased as baseline LDL-C decreased below 2.2 mmol/L. Multivariable Cox regression confirmed LDL-C as an independent protective factor for OS (HR=0.714, 95% CI: 0.539-0.947, <i>P</i>=0.019). KM analysis demonstrated significantly inferior OS in the low LDL-C cohort compared to the high LDL-C group (<i>P</i>=0.013). The subgroup-specific nomogram, integrating drinking history, Barcelona Clinic Liver Cancer stage, tumor number, and thrombin time, exhibited good discrimination (C-index=0.686; 3- and 5-year AUCs=0.752 and 0.696, respectively), accurate calibration, and positive clinical benefit. Furthermore, the model achieved secondary risk stratification within this subgroup (<i>P</i><0.0001).</p><p><strong>Conclusion: </strong>Lower baseline LDL-C is an independent predictor of worse OS. The developed subgroup-specific nomogram provides an objective tool for secondary risk stratification, aiding personalized therapeutic management for this high-risk population.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"616354"},"PeriodicalIF":3.9,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295341","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}