Journal of Hepatocellular Carcinoma最新文献

{"title":"ALBI Grade Enables Risk Stratification for Bleeding Events and Refines Prognostic Prediction in Advanced HCC Following Atezolizumab and Bevacizumab.","authors":"Bernardo Stefanini, Claudia Angela Maria Fulgenzi, Bernhard Scheiner, James Korolewicz, Jaekyung Cheon, Naoshi Nishida, Celina Ang, Thomas U Marron, Y Linda Wu, Anwaar Saeed, Brooke Wietharn, Lorenza Rimassa, Angelo Pirozzi, Antonella Cammarota, Tiziana Pressiani, Matthias Pinter, Lorenz Balcar, Yi-Hsiang Huang, Aman Mehan, Samuel Phen, Caterina Vivaldi, Francesca Salani, Gianluca Masi, Dominik Bettinger, Arndt Vogel, Martin Schönlein, Johann von Felden, Kornelius Schulze, Henning Wege, Adel Samson, Peter R Galle, Masatoshi Kudo, Giulia Francesca Manfredi, Ciro Celsa, Nichola Awosika, Alessio Cortellini, Amit G Singal, Rohini Sharma, Hong Jae Chon, Francesco Tovoli, Fabio Piscaglia, David James Pinato, Antonio D'Alessio","doi":"10.2147/JHC.S462701","DOIUrl":"10.2147/JHC.S462701","url":null,"abstract":"<p><strong>Background and aims: </strong>Atezolizumab and bevacizumab (A+B) are recommended for treating unresectable hepatocellular carcinoma (HCC). Although highly effective, A+B can lead to potentially life-threatening adverse events including bleeding. We investigated whether albumin-bilirubin (ALBI) grade identifies patients with a higher risk of bleeding and its impact on prognosis than the Child-Pugh (CP) score.</p><p><strong>Methods: </strong>We performed a multicenter retrospective study of 15 tertiary referral centers that consecutively treated patients with A+B. We analyzed the association between the ALBI grade and gastrointestinal bleeding using the χ2 test. Overall survival (OS) stratified by ALBI was estimated using the Kaplan-Meier method and the predictive value for the 6-months OS landmark with ROC curves.</p><p><strong>Results: </strong>Of the 368 patients included in the analysis, 163 (44.3%), 192 (52.2%) and 13 (3.5%) had ALBI 1, ALBI 2, and ALBI 3, respectively. ALBI grade was associated with a 3-fold increase in bleeding risk (3.1% in ALBI 1 vs 10.2% in ALBI 2/3, p=0.008). Among 192 patients with pre-treatment EGD, G2 and G3 varices were associated with an increased risk of bleeding, whereas G1 varices had a similar risk as no varices. Patients with ALBI 1 achieved a longer median OS (not reached; 95% CI, 24.9-33.7), than ALBI 2 (9.7 months; 95% CI, 7.0-12.3) or ALBI 3 (5.6 months; 95% CI, 0.1-12.0). ALBI outperformed the CP score for predicting 6-month OS with an AUC 0.79 of ALBI versus 0.71 for the CP score (p=0.01).</p><p><strong>Conclusion: </strong>A Higher ALBI grade was associated with an increased risk of gastrointestinal bleeding after receiving A+B, and outperformed the CP score in predicting worse survival.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"671-683"},"PeriodicalIF":4.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811544","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-Based Model Used for Predicting the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B.","authors":"Tong Wu, Jianguo Yan, Feixiang Xiong, Xiaoli Liu, Yang Zhou, Xiaomin Ji, Peipei Meng, Yuyong Jiang, Yixin Hou","doi":"10.2147/JHC.S498463","DOIUrl":"10.2147/JHC.S498463","url":null,"abstract":"<p><strong>Object: </strong>Currently, predictive models that effectively stratify the risk levels for hepatocellular carcinoma (HCC) are insufficient. Our study aimed to assess the 10-year cumulative risk of HCC among patients suffering from chronic hepatitis B (CHB) by employing an artificial neural network (ANN).</p><p><strong>Methods: </strong>This research involved 1717 patients admitted to Beijing Ditan Hospital of Capital Medical University and the People's Liberation Army Fifth Medical Center. The training group included 1309 individuals from Beijing Ditan Hospital of Capital Medical University, whereas the validation group contained 408 individuals from the People's Liberation Army Fifth Medical Center. By performing a univariate analysis, we pinpointed factors that had an independent impact on the development of HCC, which were subsequently employed to create the ANN model. To evaluate the ANN model, we analyzed its predictive accuracy, discriminative performance, and clinical net benefit through measures including the area under the receiver operating characteristic curve (AUC), concordance index (C-index), and calibration curves.</p><p><strong>Results: </strong>The cumulative incidence rates of HCC over a decade were observed to be 3.59% in the training cohort and 4.41% in the validation cohort. We incorporated nine distinct independent risk factors into the ANN model's development. Notably, in the training group, the area under the receiver operating characteristic (AUROC) curve for the ANN model was reported as 0.929 (95% CI 0.910-0.948), and the C-index was 0.917 (95% CI 0.907-0.927). These results were significantly superior to those of the mREACHE-B(0.700, 95% CI 0.639-0.761), mPAGE-B(0.800, 95% CI 0.757-0.844), HCC-RESCUE(0.787, 95% CI 0.732-0.837), CAMD(0.760, 95% CI 0.708-0.812), REAL-B(0.767, 95% CI 0.719-0.816), and PAGE-B(0.760, 95% CI 0.712-0.808) models (p < 0.001). The ANN model proficiently categorized patients into low-risk and high-risk groups based on their 10-year projections. In the training cohort, the positive predictive value (PPV) for the incidence of liver cancer in low-risk individuals was 92.5% (95% CI 0.921-0.939), whereas the negative predictive value (NPV) stood at 88.2% (95% CI 0.870-0.894). Among high-risk patients, the PPV reached 94.6% (95% CI 0.936-0.956) and the NPV was 90.2% (95% CI 0.897-0.917). These results were also confirmed in the independent validation cohort.</p><p><strong>Conclusion: </strong>The model utilizing artificial neural networks demonstrates strong performance in personalized predictions and could assist in assessing the likelihood of a 10-year risk of HCC in patients suffering from CHB.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"659-670"},"PeriodicalIF":4.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803496","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":"Access to Medical Research is a Basic Human Right: A Roadmap to Research Integration Into a Practical Hepatocellular Carcinoma Treatment Allocation Algorithm (HCC-TAA).","authors":"Ahmed Omar Kaseb","doi":"10.2147/JHC.S523470","DOIUrl":"10.2147/JHC.S523470","url":null,"abstract":"","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"649-657"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763221","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 Chemotherapy Response-Related Gene Signature and DNAJC8 as Key Mediators of Hepatocellular Carcinoma Progression and Drug Resistance.","authors":"Yan Ye, Yanmei Zeng, Shenggang Huang, Chunping Zhu, Qingshui Wang","doi":"10.2147/JHC.S506706","DOIUrl":"10.2147/JHC.S506706","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy resistance in hepatocellular carcinoma presents a significant challenge to improved patient outcomes. Identifying genes associated with chemotherapy response can enhance treatment strategies and prognostic models.</p><p><strong>Methods: </strong>We analyzed the expression of chemotherapy response-related gene in hepatocellular carcinoma using TCGA and GSE109211 cohorts. We constructed a prognostic model using Least Absolute Shrinkage and Selection Operator (LASSO) analysis and assessed its efficacy using Kaplan-Meier survival analysis. Additionally, we evaluated the immune landscape and gene mutation profiles between different chemotherapy response-related gene (CRRG) subtypes. DNAJC8's role in hepatocellular carcinoma cell functions and chemotherapy resistance was further explored through gene knockdown experiments in vitro and in vivo.</p><p><strong>Results: </strong>Differential expression analysis identified 220 common genes associated with chemotherapy response. The prognostic model incorporating seven key genes efficiently distinguished responders from non-responders and indicated poorer overall survival for the CRRG-high subtype. The CRRG value correlated with tumor stage and grade, and mutation profiles showed distinct patterns between CRRG subtypes. The CRRG-high subtype exhibited an immune-suppressive phenotype with higher expression of PD-L1 and CTLA-4. High DNAJC8 expression was linked to poor prognosis in multiple cohorts. Knocking down DNAJC8 significantly inhibited hepatocellular carcinoma cell proliferation, migration, invasion, and reduced sorafenib IC50.</p><p><strong>Conclusion: </strong>The seven-gene CRRG model, particularly DNAJC8, holds potential for predicting chemotherapy response and serves as a therapeutic target in hepatocellular carcinoma.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"579-595"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700657","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":"The Expression of Ferroptosis-Related Genes in Hepatocellular Carcinoma and Their Relationships With Prognosis.","authors":"Hongxu Li, Xinyue Hu, Li Wang, Xiangran Gu, Shibin Chen, Yixuan Tang, Yuan Chen, Jin Chen, Zhengrong Yuan, Yajie Wang","doi":"10.2147/JHC.S500394","DOIUrl":"10.2147/JHC.S500394","url":null,"abstract":"<p><strong>Background: </strong>Ferroptosis, a form of cell death discovered in recent years, is expected to provide new targets for the diagnosis and treatment of hepatocellular carcinoma (HCC) through further research.</p><p><strong>Methods: </strong>Based on data from The Cancer Genome Atlas (TCGA), we screened HCC-associated genes from 259 candidate genes in the FerrDb database. The screened genes were subjected to differential expression analysis, survival analysis, correlation analysis with clinical data, and univariate and multivariate Cox regression analysis. The results were validated with the Gene Expression Profiling Interactive Analysis 2 (GEPIA2) database and the Human Protein Atlas (HPA) database, and signaling pathways were analyzed with the Gene Set Enrichment Analysis (GSEA) enrichment analysis. Human normal hepatocytes and different liver cancer cell lines were used to verify the expression levels of genes, using quantitative reverse transcription PCR (RT-qPCR).</p><p><strong>Results: </strong>Eight ferroptosis-related genes were finally selected, including <i>ACSL3, ASNS, CHMP5, MYB, PCK2, PGD, SLC38A1</i>, and <i>YY1AP1</i>. The expression of eight genes except <i>PCK2</i> was significantly correlated with a lower survival rate of HCC, and the expression of <i>PCK2</i> showed a correlation with a higher survival rate of HCC. The expression of all eight genes was also correlated with clinical traits. GSEA enrichment analysis obtained many pathways such as apoptosis, endocytosis, pathways in cancer, Wnt signaling pathway, primary bile acid biosynthesis, and fatty acid metabolism pathway.</p><p><strong>Conclusion: </strong>The <i>ACSL3, ASNS, CHMP5, MYB, PCK2, PGD, SLC38A1</i>, and <i>YY1AP1</i> genes may become markers and new targets for early diagnosis and prognostic assessment of HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"629-648"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700664","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":"Prediction Model of Survival in Unresectable HCC with Central Bile Duct Invasion Receiving TACE After Biliary Drainage: TEMP Score.","authors":"Wenzhe Fan, Xinlin Zheng, Weihong Zhang, Bowen Zhu, Yanqin Wu, Miao Xue, Rong Tang, Zhen Huang, Liangliang Qiao, Mingjian Lu, Jian Wu, Yiyang Tang, Jinghua Chen, Shugui Huang, Mingjun Bai, Jiaping Li","doi":"10.2147/JHC.S505328","DOIUrl":"10.2147/JHC.S505328","url":null,"abstract":"<p><strong>Purpose: </strong>Central bile duct invasion (BDI) by hepatocellular carcinoma (HCC) is rare and associated with poor prognosis, lacking treatment guidelines. While transarterial chemoembolization (TACE) is often used for unresectable cases, determining optimal candidates post-biliary drainage is controversial. We aim to develop a prognostic prediction model for unresectable HCC (uHCC) patients with central BDI receiving sequential TACE after successful biliary drainage.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 267 uHCC patients with central BDI receiving successful biliary drainage and sequential TACE from seven tertiary centers (2015-2021), divided into training (n=187) and validation (n=80) sets. Using Cox proportional-hazards regression model, we identified key prognostic indicators for overall survival (OS) and constructed a prediction model.</p><p><strong>Results: </strong>Pre-TACE total bilirubin (TBil) values, extrahepatic spread (EHS), multiple intrahepatic tumors (MIT), and portal vein tumor thrombus (PVTT) were identified as the significant clinical indicators for OS. These four parameters were included in a novel prediction model, named TEMP score, which could successfully categorize patients in the training set into three distinct risk grades with median OS of 26.9, 9.4, and 5.8 months, respectively. The TEMP score predicted the time-dependent areas under the receiver operating characteristic curves for OS at 6 months, 1 year, and 2 years of 0.813/0.907, 0.833/0.782, and 0.838/0.811 in the training and validation sets, with corresponding C-indices of 0.812/0.929, 0.829/0.761, and 0.818/0.791, respectively, outperforming other currently available models in both cohorts. The calibration curve of the model for predicting OS presented good consistency between observations and predictions in both the training set and validation set.</p><p><strong>Conclusion: </strong>The TEMP score effectively stratifies the prognosis of uHCC patients with central BDI who have undergone successful bile drainage and sequential TACE, helping to identify those who may benefit from TACE treatment.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"615-628"},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700660","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":"Combined TACE with Targeted and Immunotherapy versus TACE Alone Improves DFS in HCC with MVI: A Multicenter Propensity Score Matching Study.","authors":"Xiaokun Chen, Xiangan Wu, Wei Peng, Liguo Liu, Xiao Liu, Xueshuai Wan, Haifeng Xu, Yongchang Zheng, Haitao Zhao, Yilei Mao, Xin Lu, Xinting Sang, Xiaoyan Chang, Kang Zhou, Jie Pan, Mei Guan, Dandan Hu, Haidong Tan, Yaojun Zhang, Shunda Du","doi":"10.2147/JHC.S504016","DOIUrl":"10.2147/JHC.S504016","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) with microvascular invasion (MVI) is associated with high recurrence and poor survival outcomes. Although adjuvant therapies such as transcatheter arterial chemoembolization (TACE), targeted therapy, and immunotherapy show potential in improving outcomes, the optimal postoperative treatment strategy remains undetermined. This study evaluates the efficacy of different adjuvant treatments on disease-free survival (DFS) and overall survival (OS) in HCC patients with MVI following curative resection.</p><p><strong>Methods: </strong>A retrospective cohort of 409 HCC patients with MVI who underwent curative resection from three clinical centers between 2017 and 2024 was analyzed. Patients were stratified into three groups: TACE alone (n=132), TACE + targeted therapy (n=58), and TACE + targeted immunotherapy (n=68). Propensity score matching (PSM) was employed to balance confounding factors. Kaplan-Meier survival curves and Cox regression models were used to assess DFS and OS. A nomogram was constructed for individualized DFS prediction.</p><p><strong>Results: </strong>After PSM, both the TACE + targeted therapy and TACE + targeted immunotherapy groups exhibited significantly prolonged DFS compared to TACE alone (median DFS: 16 vs 22 and 21 months, respectively; p=0.027). No significant differences were observed in OS across the groups. The nomogram for DFS demonstrated robust predictive performance, with a C-index of 0.709 and 0.645 in the training and validation cohorts, respectively, supporting its utility in clinical decision-making.</p><p><strong>Conclusion: </strong>In HCC patients with MVI, adjuvant TACE combined with targeted therapy or targeted immunotherapy significantly enhances DFS, though no OS benefit was observed. The developed nomogram provides a reliable tool for risk stratification and personalized postoperative management in this high-risk patient population.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"561-577"},"PeriodicalIF":4.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692239","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":"Study on the Mechanism of QRICH1 Mediating PRMT1 to Regulate the Arginine Methylation Modification of cGAS to Promote Arsenics-Induced Pyroptosis in Hepatocellular Carcinoma Cells.","authors":"Jiayuan Zhang, Tian Tian, Shanshan Tian, Jinhai Yao, Yingwan Zhang, Rujia Xie, Ting Yang, Bing Han","doi":"10.2147/JHC.S505266","DOIUrl":"10.2147/JHC.S505266","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the mechanism of action of arsenic-based agents against hepatocellular carcinoma (HCC) and to identify effective drug targets for HCC treatment.</p><p><strong>Methods: </strong>Huh7 and HepG2 cells treated with NaAsO2 were assessed for cell viability, pyroptosis, migration, and invasion after undergoing lentiviral transfection. An orthotopic liver tumor model was established and divided into a model group and a treatment group. Proteins associated with QRICH1, PRMT1, cGAS-STING, and the classical pyroptosis pathway were quantified using Western blotting. The intracellular expression and localization of PRMT1 and NLRP3 in HCC were analyzed through cellular immunofluorescence. Co-immunoprecipitation (Co-IP) was performed to examine the protein interactions between PRMT1 and cGAS, as well as between STING and NLRP3. Chromatin immunoprecipitation (ChIP) was used to confirm QRICH1 enrichment in the PRMT1 promoter region.</p><p><strong>Results: </strong>NaAsO2 treatment significantly inhibited the proliferation of Huh7 and HepG2 cells and effectively blocked their migration and invasion capabilities, while promoting cellular pyroptosis. Quantitative polymerase chain reaction(QRCR) and ChIP assays confirmed that NaAsO2 regulates PRMT1 expression by down-regulate QRICH1 binding in the PRMT1 promoter region. Additionally, NaAsO2 decreased the expression of the QRICH1-PRMT1 complex and upregulated the cGAS-STING signaling pathway, activating the downstream NLRP3-dependent classical pyroptosis pathway. Overexpression of QRICH1 reversed these effects.</p><p><strong>Conclusion: </strong>NaAsO2 inhibits the expression of the QRICH1-PRMT1 axis, activates cGAS-STING signaling pathway transduction, and induces pyroptosis in HCC cells, thereby increasing the infiltration of immune cells in liver cancer tissues.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"597-614"},"PeriodicalIF":4.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692368","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":"Radiation Segmentectomy or Ablative External Beam Radiation Therapy as Initial Treatment for Solitary Hepatocellular Carcinoma: A Multicenter Experience.","authors":"Cynthia De la Garza-Ramos, S Ali Montazeri, Jordan D LeGout, Andrew R Lewis, Gregory T Frey, Ricardo Paz-Fumagalli, Christopher L Hallemeier, Michael S Rutenberg, Jonathan B Ashman, Beau B Toskich","doi":"10.2147/JHC.S507267","DOIUrl":"10.2147/JHC.S507267","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation segmentectomy (RS) and ablative external beam radiation therapy (EBRT) are now accepted, definitive, local therapies for hepatocellular carcinoma (HCC). This report aimed to describe the clinical outcomes of RS and EBRT for treatment-naïve, solitary, HCC.</p><p><strong>Methods: </strong>A multicenter retrospective review was performed of all patients treated with RS or EBRT from March 2016 through September 2023. Inclusion criteria were initial treatment for solitary HCC ≤8 cm and absence of macrovascular invasion or extrahepatic disease. Outcomes were censored for liver transplantation (LT).</p><p><strong>Results: </strong>Eighty-six patients (RS: 58; EBRT: 28) met inclusion criteria. The EBRT cohort had older patients (median 76 vs 66 years, p < 0.001), larger tumors (median 3.7 vs 2.4 cm, p < 0.001), and worse performance status (p = 0.02). The RS cohort had more patients with ≥ grade 3 liver fibrosis (p < 0.001). Radiologic complete response (rCR) was achieved in 97% of RS and 82% of EBRT patients (p = 0.02). Median time to rCR was 1 month (95% CI: 0.9-1.1) after RS and 7 months (95% CI: 6-7) after EBRT (p < 0.001). The 1-year local control was 97% vs 93% for RS and EBRT, respectively (p = 0.80). Subsequent LT was performed in 48% of RS and 11% of EBRT patients with tumor complete pathologic response rates of 76% (n=22/28) and 33% (n=1/3), respectively. Progression free survival at 1-year was 87% after RS vs 80% after EBRT (p = 0.26). 1- and 2-year overall survival was 88% and 85% after RS vs 84% and 59% after EBRT (p = 0.34).</p><p><strong>Conclusion: </strong>RS and EBRT are effective therapies for solitary HCC. Treatment should be determined via multidisciplinary discussion based on individual patient characteristics.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"553-559"},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649254","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":"Lasso-Based Nomogram for Predicting Early Recurrence Following Radical Resection in Hepatocellular Carcinoma.","authors":"Guoqun Zheng, Minjie Zheng, Peng Hu, Yu Zhu, Wenlong Zhang, Fabiao Zhang","doi":"10.2147/JHC.S510581","DOIUrl":"10.2147/JHC.S510581","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a common malignancy with a high recurrence rate following curative resection. This study aimed to identify factors contributing to early recurrence (within 2 years) and develop a Lasso-based nomogram for individualized risk assessment.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 206 hCC patients who underwent curative resection at Taizhou Hospital, Zhejiang Province, from January 2019 to August 2022. Patients were randomly divided into training (n=144) and validation (n=62) cohorts. Lasso regression was used to identify potential recurrence risk factors among 17 candidate predictors. A Cox proportional hazards model was constructed based on variables selected by Lasso. Model performance was assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Five independent predictors of early HCC recurrence were identified: age, serum alanine aminotransferase (ALT) levels, cirrhosis, tumor diameter, and microvascular invasion (MVI). The nomogram demonstrated area under the curve (AUC) values for recurrence-free survival (RFS) of 0.828 (95% confidence interval [CI]: 0.753-0.904) at 1 year, 0.799 (95% CI: 0.718-0.880) at 2 years, and 0.742 (95% CI: 0.642-0.842) at 5 years in the training cohort. The corresponding AUCs in the validation cohort were 0.823 (95% CI: 0.686-0.960), 0.804 (95% CI: 0.686-0.922), and 0.857 (95% CI: 0.722-0.992) at 1, 2 and 5 years, respectively. Calibration curves and DCA confirmed the nomogram's high accuracy and clinical utility.</p><p><strong>Conclusion: </strong>The Lasso-Cox regression nomogram effectively predicts HCC recurrence within two years post-hepatectomy, providing a valuable tool for personalized postoperative management to improve patient outcomes.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"539-552"},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649239","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}