Journal of Hepatocellular Carcinoma最新文献

{"title":"Individualized Risk Stratification for Early Recurrence of Hepatocellular Carcinoma: A Clinical Tool Derived from a Large-Scale (n=3084) Cohort Study.","authors":"Xuanyi Zhu, Yiteng Zhao, Muyan Li, Shugeng Zhang","doi":"10.2147/JHC.S623497","DOIUrl":"10.2147/JHC.S623497","url":null,"abstract":"<p><strong>Introduction: </strong>Early recurrence (typically within 2 years) following curative liver resection remains the primary obstacle to long-term survival in patients with hepatocellular carcinoma (HCC). Traditional linear staging systems frequently fail to capture the non-linear clinical and biological interactions driving early relapse. This study aimed to develop and validate a methodologically rigorous machine learning framework for precision post-hepatectomy risk stratification, and to deploy an interactive clinical tool.</p><p><strong>Patients and methods: </strong>In this large-scale retrospective cohort study, we analyzed 3084 HCC patients who underwent curative resection. To strictly prevent data leakage and ensure generalizability, the cohort was partitioned into training (60%), validation (20%), and independent test (20%) sets prior to any preprocessing. Six ML algorithms were evaluated, and SHapley Additive exPlanations (SHAP) were employed to decode model transparency. A web-based calculator was subsequently deployed for clinical use.</p><p><strong>Results: </strong>XGBoost emerged as the optimal model, achieving an area under the curve (AUC) of 0.891 (95% CI: 0.865-0.915) on the independent test set, significantly outperforming traditional logistic regression (P < 0.0001). Using a rigorously optimized probability threshold of 0.310, the model yielded a sensitivity of 87.6% (95% CI: 83.5%-91.4%) and a specificity of 70.3% (95% CI: 65.4%-75.2%), with all confidence intervals derived from 2,000 bootstrap resamples. SHAP analysis identified tumor capsule integrity, neutrophil-to-eosinophil ratio (NER), and alpha-fetoprotein (AFP) as the most critical predictors of recurrence.</p><p><strong>Conclusion: </strong>This methodologically rigorous ML framework provides a highly sensitive, data-driven tool for individual risk stratification. By identifying high-risk patients, the web-based calculator can guide clinicians in implementing intensified postoperative surveillance and selecting candidates for targeted adjuvant interventions, ultimately improving oncological outcomes in HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"623497"},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850960","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":"Application of the AAPS (AFP-ALBI-PIVKA-II-Serum Albumin) Scoring System in Efficacy Monitoring of Hepatocellular Carcinoma Treated with PD-1 Inhibitor Combined with Transcatheter Arterial Chemoembolization (TACE).","authors":"Huan Yang, Lingyang Kong, Wenjing Ge, Qingwei Li","doi":"10.2147/JHC.S621537","DOIUrl":"10.2147/JHC.S621537","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) lacks reliable serological biomarkers for monitoring programmed death-1 (PD-1) inhibitor plus transcatheter arterial chemoembolization (TACE). We aimed to validate the prognostic value of alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) reductions and establish a practical combined model (AAPS: AFP-ALBI-PIVKA-II-serum albumin).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 139 HCC patients treated with PD-1 inhibitor plus TACE. Patients were stratified by ≥50% vs <50% reductions in AFP and PIVKA-II. Survival was assessed by Kaplan-Meier with Log rank tests; prognostic factors by multivariate Cox regression. The AAPS score incorporated AFP reduction, PIVKA-II reduction, albumin-bilirubin (ALBI) grade, and serum albumin. X-tile identified optimal cutoffs: AFP 34%, PIVKA-II 73%, and AAPS 5 points, defining low-risk (5-8) and high-risk (0-4) groups. Model performance was evaluated by C-index, bootstrap-corrected area under the curve (AUC), calibration, and decision curve analysis (DCA). All tests were two-tailed, P < 0.05 considered significant.</p><p><strong>Results: </strong>Patients with ≥50% biomarker reduction achieved higher objective response rate (ORR) and longer progression-free survival (PFS: AFP, 13.17 vs 10.72 months, P=0.009; PIVKA-II, 13.11 vs 10.87 months, P=0.012) and overall survival (OS: AFP, 14.50 vs 13.40 months; PIVKA-II, 14.60 vs 13.32 months). Multivariate analysis confirmed AFP and PIVKA-II reduction, and albumin as independent prognostic factors. ALBI grade, as an aestablished prognostic indicators in HCC, was included in the AAPS model based on its clinical relevance.The AAPS model demonstrated improved predictive accuracy for ORR, PFS, and OS versus single biomarkers.</p><p><strong>Conclusion: </strong>AFP/PIVKA-II reductions correlated with treatment response in HCC patients receiving PD-1 inhibitor plus TACE. The AAPS scoring model, integrating dynamic biomarkers with liver function, refines prognostic stratification and may guide personalized therapy. This serum-based assessment is unaffected by post-TACE inflammation or edema, complementing imaging evaluation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"621537"},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829413","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":"Efficacy Analysis of Capsule Integrity and TACE Combined with Microwave Ablation versus Microwave Ablation Alone for Primary Hepatocellular Carcinoma.","authors":"Yang Fang, Zhongke Yan, Zhezhu Han, Xuezhe Piao, Songnan Zhang","doi":"10.2147/JHC.S626276","DOIUrl":"10.2147/JHC.S626276","url":null,"abstract":"<p><strong>Background: </strong>Locoregional minimally invasive therapies have become important treatment options for patients with early- and intermediate-stage hepatocellular carcinoma (HCC). However, the integrity of the tumor pseudocapsule may influence the ablation margin and local tumor control achieved by microwave ablation (MWA), potentially contributing to heterogeneous treatment outcomes. This real-world study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with MWA compared with MWA alone in HCC patients stratified according to pseudocapsule integrity.</p><p><strong>Methods: </strong>We retrospectively enrolled 68 patients with early-stage HCC who underwent MWA alone or TACE combined with MWA at our institution between May 2017 and December 2022. Propensity score matching (PSM) was performed to reduce baseline imbalances and selection bias. Patients were categorized into the TACE plus MWA group (T+M group) and the MWA-alone group (M group) according to the treatment modality. Based on preoperative imaging assessment, patients were further stratified into intact and incomplete pseudocapsule subgroups, and treatment outcomes were compared between the T+M and M groups within each subgroup. The primary endpoint was progression-free survival (PFS), and the secondary endpoint was safety.</p><p><strong>Results: </strong>After 1:1 PSM, no significant difference in median PFS was observed between the TACE plus MWA group and the MWA-alone group in the overall cohort. In the incomplete pseudocapsule subgroup, patients receiving TACE plus MWA demonstrated significantly longer median PFS than those receiving MWA alone (51.1 vs 10.4 months, P < 0.05). The 1-year and 3-year PFS rates were 85% and 62% in the T+M group, compared with 46% and 28% in the M group, respectively. Multivariable Cox regression analysis identified treatment modality as an independent prognostic factor for PFS in patients with incomplete pseudocapsules (hazard ratio [HR], 0.301; 95% confidence interval [CI], 0.094-0.962; P = 0.043). In the intact pseudocapsule subgroup, the median PFS was 52.1 months in the T+M group and was not reached in the M group, with no statistically significant difference observed between the groups (P > 0.05). No grade ≥3 treatment-related adverse events were observed in either group.</p><p><strong>Conclusion: </strong>In patients with early-stage HCC, TACE combined with MWA did not demonstrate a significant overall PFS benefit compared with MWA alone. However, among patients with incomplete pseudocapsules, the combination therapy was associated with prolonged PFS. These findings suggest that TACE combined with MWA may represent a potential treatment strategy for HCC patients with incomplete pseudocapsules, a subgroup characterized by a higher risk of recurrence.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"626276"},"PeriodicalIF":3.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829439","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":"Association of Combined Iodine-125 Seed Implantation and Atezolizumab/Bevacizumab with Improved Outcomes in Recurrent Hepatocellular Carcinoma After Hepatectomy: A Comparative Retrospective Analysis.","authors":"Jun Chen, Tianyou Shao, Bi Sheng","doi":"10.2147/JHC.S619755","DOIUrl":"10.2147/JHC.S619755","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated whether combining Iodine-125 (125I) seed implantation with atezolizumab and bevacizumab (Atezo/Bev) improves outcomes compared to Atezo/Bev alone in patients with recurrent HCC after hepatectomy.</p><p><strong>Methods: </strong>This retrospective comparative analysis included patients with recurrent HCC after hepatectomy treated between January 2020 and December 2025. Patients were divided into a Combination Group (125I seed implantation plus Atezo/Bev, n=79) and a Control Group (Atezo/Bev alone, n=94). To minimize selection bias, propensity score matching (PSM) was performed using a 1:1 nearest-neighbor algorithm, yielding 62 matched pairs. A 14-day landmark analysis was conducted to address immortal-time bias. Primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. Tumor response was assessed by RECIST 1.1. Treatment effects were estimated using stratified Cox proportional hazards models with matched pairs as strata, and a multivariable stratified Cox model was performed as a sensitivity analysis.</p><p><strong>Results: </strong>After propensity score matching, 62 matched pairs were obtained with satisfactory covariate balance (all SMDs < 0.1). The Combination Group showed significantly higher objective response rate (63.3% vs 46.8%, <i>P</i> = 0.03) and disease control rate (81.0% vs 63.8%, <i>P</i> = 0.012). In the matched cohort, median PFS was significantly longer in the Combination Group (16.0 months vs 8.0 months; HR = 0.49, 95% CI: 0.35-0.68, <i>P</i> < 0.001), as was median OS (31.0 months vs 16.0 months; HR = 0.53, 95% CI: 0.38-0.74, <i>P</i> < 0.001). Stratified Cox regression confirmed treatment modality as an independent prognostic factor for both OS and PFS, with consistent results in multivariable sensitivity analyses. Grade 3-4 treatment-related adverse events occurred in 22.8% (18/79) of the Combination Group and 20.2% (19/94) of the Control Group (<i>P</i> = 0.68). Liver-related AEs and hepatic decompensation events were comparable between groups (all <i>P</i> > 0.05), with no radiation-induced liver disease observed. Procedural complications from seed implantation were minimal (pneumothorax in 2.5%, self-limited hematoma in 1.3%), with no procedure-related mortality.</p><p><strong>Conclusion: </strong>In this retrospective comparative analysis, the addition of CT/ultrasound-guided 125I seed implantation to Atezo/Bev was associated with improved tumor response and survival outcomes compared to Atezo/Bev alone in patients with recurrent HCC after hepatectomy, with a manageable safety profile. These findings suggest a potential benefit of combining local brachytherapy with systemic immunotherapy, but causality cannot be established due to the observational design. Prospective randomized trials are warranted to confirm these results.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"619755"},"PeriodicalIF":3.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818612","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":"Shikonin in Hepatocellular Carcinoma: Bridging Metabolic Disruption and Immunomodulation.","authors":"Yongjing Dong, Meimei Wang, Ying Cao, Xiaoni Kou","doi":"10.2147/JHC.S637277","DOIUrl":"10.2147/JHC.S637277","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is characterized by extensive metabolic changes and an immunosuppressive microenvironment, which interact to promote tumor progression, drug resistance and immune escape. Shikonin, a natural naphthoquinone, exhibits broad antitumor activity and may simultaneously affect metabolic and immune pathways. This review synthesizes current evidence on the role of shikonin in HCC through the metabolic-immune axis. Shikonin suppresses glycolysis mediated by pyruvate kinase M2 (PKM2), disrupts the signaling axis involving PKM2, prolyl hydroxylase domain 3 (PHD3), and hypoxia-inducible factor 1-alpha (HIF-1α), impairs mitochondrial function, and promotes reactive oxygen species accumulation, thereby destabilizing metabolic homeostasis and adaptive survival. It also induces apoptosis and immunogenic cell death (ICD)-associated responses in HCC-related models, whereas evidence for necroptosis remains limited and requires further causal validation. In nanodelivery-based HCC models, the release of damage-associated molecular patterns (DAMPs) has been associated with dendritic cell maturation, antigen presentation, cluster of differentiation 8 (CD8⁺) T-cell activation, and improved responses to immune checkpoint blockade. Shikonin has also shown potential in overcoming multidrug resistance and in smart delivery platforms. In conclusion, shikonin emerges as a multi-target agent that acts as a molecular bridge between metabolic stress and immunomodulation, although the evidence for specific mechanistic modules varies in strength.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"637277"},"PeriodicalIF":3.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813107","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":"From Tumor to Tumor-Spleen: MRI Habitat Heterogeneity for Predicting Immunotherapy Outcome in Advanced Hepatocellular Carcinoma.","authors":"Wenhua Bai, Jinqi Zhang, Kuo Li, Xinming Zhao, Hongmei Zhang, Zheng Zhu","doi":"10.2147/JHC.S615844","DOIUrl":"10.2147/JHC.S615844","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a pretreatment MRI-based radiomics model that integrates tumor and spleen habitat heterogeneity features for predicting objective response to immunotherapy and stratifying progression-free survival (PFS) in patients with advanced hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>In this retrospective study, 107 patients with advanced HCC receiving first-line immunotherapy were included. Tumor and spleen habitats were independently identified on portal venous phase MRI using K-means clustering. High-throughput radiomic features were extracted from each habitat, and their spatial heterogeneity was quantified to generate predictive signatures. These features were integrated into a weighted fusion model (RadCVTS) to predict objective response. Model performance was evaluated in a temporal validation cohort, with comparison against a tumor-only heterogeneity model (RadCVT) and a conventional tumor radiomics model (RadT). Association with PFS was assessed using Kaplan-Meier analysis and Cox regression.</p><p><strong>Results: </strong>The RadCVTS demonstrated superior predictive performance compared to both the RadCVT and the conventional RadT,with AUCs of 0.958 vs 0.828 vs 0.789, respectively, in the temporal validation cohort. Patients stratified as high-risk by the model had significantly shorter PFS than the low-risk group (hazard ratio: 11.44, p < 0.05). Exploratory analysis of the top two features from the tumor and spleen, respectively, revealed that patients exhibiting a \"Double-High\" imaging phenotype had a 22.5 times greater odds of response than the \"Double-Low\" group. A simplified model using only these two features also provided significant incremental value for PFS prediction (AUC = 0.802).</p><p><strong>Conclusion: </strong>The tumor-spleen combined habitat heterogeneity model demonstrated superior predictive performance over both the tumor-only heterogeneity model and the conventional tumor radiomics model, and can noninvasively predict response to immunotherapy and stratify PFS in advanced HCC, highlighting the value of the liver-spleen axis and providing a promising indicator to support personalized treatment decision making.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"615844"},"PeriodicalIF":3.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813121","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":"Multi-Target Tyrosine Kinase Inhibitors as Adjuvant Therapy for Hepatocellular Carcinoma Patients Who Achieve Complete Response After Transarterial Chemoembolization: A Real-World Study.","authors":"Wei Tang, Ya'nan Huang, Ting Wang, Jianfeng Yang, Zhenhua Zhao","doi":"10.2147/JHC.S628536","DOIUrl":"10.2147/JHC.S628536","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the role of tyrosine kinase inhibitors (TKIs) as adjuvant therapy in hepatocellular carcinoma HCC patients who achieved complete response (CR) after Transarterial chemoembolization (TACE).</p><p><strong>Materials and methods: </strong>This study retrospectively enrolled 96 patients with HCC who achieved complete response following TACE at a tertiary medical center in Zhejiang Province, China, between January 2016 and December 2024, including 55 patients in the adjuvant TKI group and 41 patients in the active surveillance group. The primary endpoint was recurrence-free survival (RFS), and the secondary endpoints were overall survival (OS) and safety.</p><p><strong>Results: </strong>The 1-year, 2-year, and 3-year RFS rates were 82.80%, 47.80%, and 32% in the tyrosine kinase inhibitors (TKI) adjuvant therapy group, compared with 63.80%, 18.20%, and 0.00% in the surveillance group, respectively. The 1-year, 3-year, and 5-year OS rates were 98%, 69.8%, and 54.10% in the TKI adjuvant therapy group, versus 92.60%, 51.30%, and 21.50% in the surveillance group, respectively. Compared to the surveillance group, the TKI adjuvant therapy group demonstrated significantly better RFS (P < 0.001) and OS (P = 0.011). The most common adverse event associated with TKI treatment was proteinuria, occurring in 14 (25.5%) cases, and all adverse events were graded as 1-2.</p><p><strong>Conclusion: </strong>Compared with surveillance alone, adjuvant therapy with TKIs prolonged RFS and OS in HCC patients who achieved CR after TACE.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"628536"},"PeriodicalIF":3.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813159","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":"Intratumoral Para-Toluenesulfonamide (PTS) Injection for Recurrent Hepatocellular Carcinoma Adjacent to the Heart: A Case Report.","authors":"Chia-Ling Chiang, Chien-Yang Liao, Mao-Yuan Lin, Chuan-Ching Yang","doi":"10.2147/JHC.S621524","DOIUrl":"10.2147/JHC.S621524","url":null,"abstract":"<p><p>Recurrent hepatocellular carcinoma (HCC) adjacent to the heart is difficult to treat when surgery and conventional locoregional therapies are no longer feasible. We report an 87-year-old man with recurrent segment VIII HCC that remained viable after radiofrequency ablation, six sessions of transarterial embolization (TAE), and stereotactic body radiation therapy (SBRT). Following multidisciplinary review and regulatory approval for compassionate-use, the patient underwent CT-guided intratumoral para-toluenesulfonamide (PTS) injection. PTS (330 mg/mL) was administered as 5.0 mL on 13 March 2025 and 6.0 mL on 17 March 2025. A small residual enhancing focus was subsequently treated with an additional 0.5 mL on 24 June 2025, giving a total cumulative volume of 11.5 mL. Serial contrast-enhanced computed tomography showed progressive loss of arterial enhancement. Complete response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) was documented in September 2025 and was sustained on follow-up CT obtained on 15 April 2026, with no evidence of local recurrence. Serum alpha-fetoprotein remained below 3.0 ng/mL and liver function was preserved. A small pneumothorax and transient post-procedural pain resolved with conservative management; no severe or life-threatening treatment-related adverse events were documented. This case suggests that CT-guided intratumoral PTS injection may represent a feasible salvage local treatment strategy for carefully selected patients with anatomically challenging recurrent HCC when established locoregional options are no longer feasible.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"621524"},"PeriodicalIF":3.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808730","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":"HAIC-Based versus TACE-Based Triple Therapy with Lenvatinib and PD-1 Inhibitors for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Retrospective Propensity Score-Matched Study.","authors":"Jun Yu, Yiran Xu, Xuehan Shen, Jinpeng Wang, Tianyin Shao, Yu Wu, Hanlong Hu, Qi Cheng, Zhiwei Zhang","doi":"10.2147/JHC.S623040","DOIUrl":"10.2147/JHC.S623040","url":null,"abstract":"<p><strong>Background: </strong>The optimal locoregional treatment to combine with lenvatinib and PD-1 inhibitors for hepatocellular carcinoma with portal vein tumor thrombus (PVTT-HCC) remains uncertain. We compared HAIC- and TACE-based triple therapy.</p><p><strong>Methods: </strong>This retrospective single-center study included 359 consecutive patients with PVTT-HCC treated with HAIC or TACE plus lenvatinib and a PD-1 inhibitor. Propensity score matching (PSM) was performed at a 1:1 ratio. Tumor response was assessed using mRECIST. Overall survival (OS), progression-free survival (PFS), conversion-to-surgery, and adverse events were compared. Time-dependent Cox models accounted for cumulative locoregional treatment sessions.</p><p><strong>Results: </strong>Among 359 patients, 161 received TACE-based therapy and 198 received HAIC-based therapy. After PSM, 139 matched pairs were analyzed. HAIC was associated with higher objective response rate (66.91% vs 42.45%) and disease control rate (82.73% vs 62.59%) than TACE (both <i>P</i><0.001). Median OS was 23.7 versus 17.1 months (HR 0.67, 95% CI 0.48-0.93; <i>P</i>=0.018), and median PFS was 7.7 versus 5.4 months (HR 0.70, 95% CI 0.54-0.91; <i>P</i>=0.008), favoring HAIC. After time-dependent adjustment, HAIC remained associated with improved OS (HR 0.61; <i>P</i>=0.003) and PFS (HR 0.73; <i>P</i>=0.011). Conversion-to-surgery was more frequent with HAIC (27.3% vs 17.4%; <i>P</i>=0.027). Overall adverse-event rates were similar (89.90% vs 88.82%; <i>P</i>=0.741), although hypertension was more frequent with HAIC (52.02% vs 38.51%; <i>P</i>=0.011).</p><p><strong>Conclusion: </strong>In patients with PVTT-HCC receiving lenvatinib and PD-1 inhibitors, HAIC-based triple therapy was associated with improved tumor response and longer OS and PFS than TACE-based therapy, with generally comparable safety. Prospective multicenter studies are warranted.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"623040"},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794045","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 Factors Analysis in Patients with Hepatocellular Carcinoma Receiving PD-1/PD-L1 Inhibitors.","authors":"Yubin Pan, Qijun Li, Honglin Tang, Guangpeng Chen, Da Li","doi":"10.2147/JHC.S623481","DOIUrl":"https://doi.org/10.2147/JHC.S623481","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced hepatocellular carcinoma (HCC); however, only a minority of patients derive benefits, and reliable biomarkers remain lacking. This study aimed to investigate the associations between peripheral blood markers, clinical characteristics, and outcomes in patients receiving programmed cell death protein-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors.</p><p><strong>Methods: </strong>Clinical and laboratory data from 101 patients treated with PD‑1/PD‑L1 inhibitors were retrospectively analyzed. Optimal cutoff values for continuous variables were determined using the X‑tile. Intergroup comparisons were performed using Pearson's chi-squared or Fisher's exact tests. Univariate Cox regression (SPSS 26.0) was used to identify potential prognostic factors (P<0.1), which were further evaluated by Log rank test and Kaplan-Meier curves. Independent prognostic factors were determined using a multivariate Cox regression analysis.</p><p><strong>Results: </strong>The factors associated with efficacy included body mass index, Child‑Pugh class, line of treatment, distant metastasis, bone metastasis, alkaline phosphatase, and total bilirubin. Prognosis‑related indicators included lung metastasis, hemoglobin, absolute neutrophil count, alkaline phosphatase, gamma‑glutamyl transferase, C‑reactive protein, and the best response.</p><p><strong>Conclusion: </strong>Based on routine clinical and hematological data, this prognostic study provides an accessible tool for personalized immunotherapy management of HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"623481"},"PeriodicalIF":3.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794057","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}