Journal of Hepatocellular Carcinoma最新文献

{"title":"Prediction of Post-Resection Prognosis of HCC According to AFP-PIVKA-II (AP) Score as a Simplified Biomarker of ADV Score: A Validation Analysis Using Korea Liver Cancer Registry Database.","authors":"Woo-Hyoung Kang, Shin Hwang, I-Ji Jeong, Deok-Bog Moon, Dong-Hwan Jung, Gi-Won Song, Young-In Yoon, Tae-Yong Ha, Gil-Chun Park","doi":"10.2147/JHC.S625029","DOIUrl":"10.2147/JHC.S625029","url":null,"abstract":"<p><strong>Background: </strong>A simplified prognostic model, the AFP-PIVKA-II (AP) score, was developed to predict outcomes after resection of hepatocellular carcinoma (HCC). Unlike the conventional ADV score, it relies only on serum biomarkers (AFP and PIVKA-II), excluding tumor size.</p><p><strong>Methods: </strong>This study included 2257 patients who underwent liver resection for HCC, using data from the Korea Liver Cancer Registry (2015-2022). The AP score's ability to predict overall survival (OS) and microvascular invasion (MVI) was evaluated and compared with radiologic and pathologic ADV scores.</p><p><strong>Results: </strong>Median preoperative AFP and PIVKA-II levels were 9.2 ng/mL and 62 mAU/mL. Increasing AP scores showed consistent association with worse OS (p < 0.001). Kaplan-Meier survival analyses using 1.0 log-, 2.0 log-, and 4.0 log-interval groupings consistently demonstrated a stepwise decline in OS with increasing AP score (all p < 0.001). At 4.0 log intervals, Harrell's c-indices for OS prediction were 0.604 (AP score), 0.681 (radiologic ADV score), and 0.677 (pathologic ADV score). For MVI prediction, the areas under the ROC curve values were 0.705, 0.733, and 0.741, respectively. Although ADV score-based models performed better overall, the AP score showed acceptable predictive ability for post-resection patient survival.</p><p><strong>Conclusion: </strong>The AP score is a simple, biomarker-based tool for estimating survival after HCC resection. While less accurate than ADV score models, its convenience supports use in settings requiring rapid assessment.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"625029"},"PeriodicalIF":3.9,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963084","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":"DCUN1D5 as a New Biomarker and Regulator of Fatty Acid Metabolism in Hepatocellular Carcinoma.","authors":"Tong Wang, Tianrun Yang, Tianze Wang, Ziming Wang, Pinsheng Han, Yi Bai, Yamin Zhang","doi":"10.2147/JHC.S617328","DOIUrl":"10.2147/JHC.S617328","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death, with limited reliable biomarkers for early diagnosis and prognosis. In this study, we explored the role of DCUN1D5, a potential biomarker, in HCC.</p><p><strong>Methods: </strong>We performed integrated bioinformatics analyses of publicly available HCC datasets, including TCGA, GEO, and ICGC, followed by in vitro experiments on HCC cell lines to validate our findings.</p><p><strong>Results: </strong>DCUN1D5 expression was significantly elevated in HCC tissues compared to normal liver tissues. High DCUN1D5 levels were associated with poor prognosis and advanced tumor stage in HCC patients. Additionally, bioinformatics analysis revealed a correlation between DCUN1D5 expression levels and both immune infiltration and immunotherapy response in hepatocellular carcinoma. Functional assays revealed that DCUN1D5 knockdown inhibited cell proliferation, migration, and invasion in HCC cells. Mechanistically, Enrichment analysis revealed significant correlations between DCUN1D5 and multiple biological pathways; specifically, we observed a negative correlation between the expression level of DCUN1D5 and fatty acid metabolism. Further cellular experiments demonstrated that knockdown of DCUN1D5 can induce accumulation of free fatty acids in hepatocellular carcinoma cells.</p><p><strong>Conclusion: </strong>In summary, our study identified DCUN1D5 as a potential biomarker for poor prognosis in HCC, high expression of DCUN1D5 are closely associated with tumor invasion and proliferation. Knockdown of DCUN1D5 was found to inhibit the proliferation, migration, and invasion of HCC cells and increases its free fatty acid accumulation. These studies suggest new possibilities for treatment strategies for HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"617328"},"PeriodicalIF":3.9,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919944","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":"Dynamic Vascular Spatiotemporal Heterogeneity on Multiphase CT for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma.","authors":"Shucheng Yang, Meng Liu, Yongjie Zhou, Jinhong Zhao, Yongming Tan, Weijia Wang","doi":"10.2147/JHC.S632045","DOIUrl":"10.2147/JHC.S632045","url":null,"abstract":"<p><strong>Purpose: </strong>Microvascular invasion (MVI) is an important determinant of postoperative recurrence in hepatocellular carcinoma (HCC) but is usually confirmed only after surgery. This study aimed to develop and externally validate a multiphase CT framework integrating dynamic vascular trajectory, spatial intratumoral heterogeneity, and deep imaging features for preoperative MVI prediction and exploratory prognostic stratification.</p><p><strong>Patients and methods: </strong>This retrospective multicenter study included 405 patients with pathologically confirmed HCC: 198 in the development cohort and 207 in two independent external-validation cohorts. Clinical variables, static multiphase radiomics, Delta vascular trajectory features, three-dimensional intratumoral heterogeneity (3D-ITH)/habitat features, and Vision Transformer (ViT) features were extracted. All preprocessing, model fitting, and threshold selection were confined to the development cohort. A capacity-constrained multimodal Transformer was compared with clinical, single-modality, simple concatenation, and tree-based models.</p><p><strong>Results: </strong>The cohort included 148 MVI-positive and 257 MVI-negative patients according to the locked blinded multireviewer reference standard. In pooled external validation, Transformer fusion achieved an area under the curve of 0.941 (95% CI, 0.906-0.969), sensitivity of 0.951, specificity of 0.754, accuracy of 0.831, negative predictive value of 0.960, and Brier score of 0.113. Corresponding AUCs were 0.957 and 0.934 in the two external cohorts. Delta-only and clinical models achieved pooled external AUCs of 0.793 and 0.675, respectively. High fusion-risk patients had poorer composite RFS/PFS than low-risk patients (hazard ratio, 2.05; 95% CI, 1.36-3.08; P < 0.001).</p><p><strong>Conclusion: </strong>The proposed dynamic vascular heterogeneity-centered framework demonstrated high external discrimination for preoperative MVI prediction in HCC and provided exploratory stratification of the available composite RFS/PFS endpoint. Prospective validation and recalibration are required before clinical implementation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"632045"},"PeriodicalIF":3.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912303","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 LASSO-RF-Cox-Derived Nomogram Incorporating Inflammatory Markers to Predict Long-Term Survival in Early-Stage Hepatocellular Carcinoma After Microwave Ablation.","authors":"Qi Zhang, Lina Sun, Jiangwei Ji, Xiaoyan Ding, Jinglong Chen","doi":"10.2147/JHC.S626041","DOIUrl":"10.2147/JHC.S626041","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify factors influencing overall survival (OS) in patients with hepatocellular carcinoma (HCC) undergoing microwave ablation (MWA) and to develop and validate a nomogram for predicting 3‑, 5‑, and 8‑year OS.</p><p><strong>Materials and methods: </strong>Data from 440 patients who received MWA at Beijing Ditan Hospital, Captical Medical University were analyzed using least absolute shrinkage and selection operator (LASSO) regression, random forest (RF), and multivariable Cox regression to identify independent prognostic factors. A prognostic nomogram was constructed and validated. OS was assessed using Kaplan-Meier curves.</p><p><strong>Results: </strong>The variables selected by both LASSO and RF were incorporated into a multivariable Cox regression model, which identified tumor number, tumor size, monocyte-to-lymphocyte ratio (MLR), white blood cell count (WBC), and diabetes as independent risk factors for OS. The predictive accuracy, reliability, and clinical utility of the model were confirmed through Harrell's concordance index (C-index), time-dependent area under the receiver operating characteristic curve (AUC) analysis, calibration curves, and decision curve analysis (DCA). Furthermore, risk stratification based on the model effectively differentiated patients into distinct prognostic subgroups.</p><p><strong>Conclusion: </strong>A nomogram based on LASSO-RF-Cox analysis was developed to predict OS in early-stage HCC patients after MWA. The model demonstrated acceptable predictive performance in internal validation, with moderate discriminative ability. This model may help identify high-risk individuals and facilitate clinical decision-making, particularly in primary care settings due to its simple and readily available predictors.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"626041"},"PeriodicalIF":3.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906170","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":"Nivolumab Plus Lenvatinib and Intra-Arterial Locoregional Therapy as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Real-World Study.","authors":"Shanzhi Gu, Yang Zhao, Haixiong Yan, Muzi Li, Guowen Li, Manping Huang, Zhengping Xiong, Bin Huang","doi":"10.2147/JHC.S625046","DOIUrl":"10.2147/JHC.S625046","url":null,"abstract":"<p><strong>Background: </strong>Although first-line triple therapy of programmed death-1 inhibitors plus lenvatinib and intra-arterial locoregional therapy has shown potential clinical benefit for unresectable hepatocellular carcinoma (HCC), it has not yet been established as a standard treatment. This real-world study evaluated the efficacy and safety of first-line combination therapy with nivolumab, lenvatinib, and intra-arterial locoregional therapy (including transarterial chemoembolization or hepatic arterial infusion chemotherapy) in this population.</p><p><strong>Methods: </strong>This retrospective study included untreated unresectable HCC patients who received nivolumab plus lenvatinib and intra-arterial locoregional therapy between 26 March 2020 and 17 October 2023. The outcomes included objective response rate (ORR), disease control rate (DCR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety.</p><p><strong>Results: </strong>A total of 52 patients were included, the majority of whom were <65 years (86.5%) and male (90.4%). Most patients had compensated liver disease, with 92.3% classified as Child-Pugh class A. The ORR was 69.2% (95% confidence interval [CI]: 54.9%-81.3%) per mRECIST and 55.8% (95% CI: 41.3%-69.5%) per RECIST version 1.1. The DCR was 100% by both criteria. The median DoR was 12.1 months per mRECIST and 10.5 months per RECIST version 1.1. With a median follow-up of 22.0 months (range: 1.6-57.3), the median PFS was 16.8 months (95% CI: 12.9-20.5) per mRECIST and 16.6 months (95% CI: 12.8-20.2) per RECIST version 1.1. The median OS was 24.9 months (95% CI: 21.7-35.6). Treatment-emergent adverse events (TEAEs) of any grade occurred in 45 patients (86.5%), with fatigue (30.8%) being the most common. Grade ≥3 TEAEs were observed in 17.3% of patients.</p><p><strong>Conclusion: </strong>First-line nivolumab plus lenvatinib and intra-arterial locoregional therapy showed encouraging antitumor activity and a manageable safety profile in unresectable HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"625046"},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906134","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":"Hepatocellular Carcinoma at a Center of Clinical Excellence in Colombia: A Real-World Cohort Study of Clinical Characteristics, Treatment Trajectories, and Survival.","authors":"Camila Torres-Vélez, Angélica Sanabria-Jiménez, Javier Amaya-Nieto, María Ariza-De La Hoz, Oscar Beltrán-Galvis, Adriana Varón-Puerta","doi":"10.2147/JHC.S613939","DOIUrl":"10.2147/JHC.S613939","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide. In middle-income settings, fragmentation of care may delay diagnosis and limit access to timely treatment. This study aimed to describe the sociodemographic and clinical characteristics, treatment patterns, and overall survival of patients with HCC managed at a Center of Clinical Excellence (CCE).</p><p><strong>Patients and methods: </strong>We conducted a retrospective descriptive cohort study of adults (≥18 years) with HCC managed at a CCE between September 2022 and December 2025. Baseline variables included etiology, comorbidities, Child-Pugh class, Model for End-Stage Liver Disease (MELD) score, Barcelona Clinic Liver Cancer (BCLC) stage, and alpha-fetoprotein (AFP) levels. Treatment strategies and clinical course, including stage migration, liver transplantation, and death, were described. Overall survival was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 134 patients were included. Median age was 67.93 years (IQR 63.12-72.59) and 61.19% were men. The most common underlying etiology was metabolic dysfunction-associated steatotic liver disease (MASLD) (34.38%). Most patients were diagnosed at early BCLC stages 0/A (64.18%; n = 86). Ablation and transarterial chemoembolization were the most frequently used treatments, and liver transplantation was performed in 9.70% of patients. After a median follow-up of 21 months, median overall survival was not reached; estimated survival was 93.8% at 1 year and 80.0% at 3 years.</p><p><strong>Conclusion: </strong>In this retrospective cohort managed at a CCE, MASLD was the most frequent underlying etiology, and patients were diagnosed at early stages BCLC stages 0/A. Treatment patterns were dominated by locoregional therapies, and median overall survival was not reached during the available follow-up period. These findings provide real-world data on HCC care in a middle-income setting and highlight the clinical relevance of describing treatment trajectories and survival within structured multidisciplinary care programs.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"613939"},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900674","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 VPS45 in HCC and Its Correlation with Immune Microenvironment.","authors":"Jiming Duan, Wenjun Zhao, Na Lv, Changhu Xie, Guoping Zhang, Lei Zhang, Renhou Zhi","doi":"10.2147/JHC.S626822","DOIUrl":"10.2147/JHC.S626822","url":null,"abstract":"<p><strong>Purpose: </strong>A growing body of research indicates that Vacuolar Protein Sorting 45 (VPS45) is essential for the development of tumours and the advancement of cancer. Its biological role and expression profile in HCC are still mostly unknown, nevertheless.</p><p><strong>Materials and methods: </strong>Using a variety of datasets, including the Tumour Immune Estimation Resource (TIMER) and Gene Expression Profiling Interactive Analysis (GEPIA), among others, we examined the existence and prognostic importance of VPS45. Functional enrichment analysis was employed to elucidate the potential mechanisms through which VPS45 may influence HCC. Additionally, we assessed the relationship between VPS45 expression and immune cell infiltration using single-sample gene set enrichment analysis (ssGSEA) and Estimation of Stromal and Immune cells in Malignant Tumour tissues using Expression data (ESTIMATE). The Tumor Immune Dysfunction and Rejection (TIDE) algorithm was leveraged to assess the sensitivity of predicted gene expression to immunotherapy. Utilizing assays including CCK-8, wound healing, and Transwell migration and invasion methods, we performed in vitro experiments on the MHCC-97H cell line to further investigate the biological significance of VPS45 in the progression of hepatocellular carcinoma (HCC).</p><p><strong>Results: </strong>According to our research, VPS45 expression is markedly elevated in HCC, and elevated VPS45 levels are associated with a worse prognosis for patients. Functional enrichment analysis showed that elevated VPS45 expression is closely linked to the activation of various oncogenic pathways. VPS45 silencing decreases HCC cell invasion, metastasis, and proliferation, according to in vitro investigations. Interestingly, it was shown that VPS45 levels showed a positive link with immunosuppressive cell populations and related genes, but a negative correlation with a number of anti-tumor immune cell types. Immunotherapy resistance is more common in patients with increased VPS45 expression.</p><p><strong>Conclusion: </strong>This study clarifies the biological role of VPS45 in hepatocellular carcinoma (HCC) and, through comprehensive database analyses combined with in vitro experiments, supports its potential as a diagnostic and predictive biomarker for HCC. In addition to its value for disease detection and prognosis, VPS45 may help predict patient response to immunotherapy.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"626822"},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900782","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 of a PNI-Based Prognostic Model for Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib-Based Triple Therapy.","authors":"Weifu Liu, Bohua Yu, Fuqun Wei, Songhui Wu, Jian He, Peishu Huang, Xiang You, Zhisheng Chen, Ziqi Lin, Shaowu Zhuang, Zhongwu Chen, Yiping Chen","doi":"10.2147/JHC.S626820","DOIUrl":"10.2147/JHC.S626820","url":null,"abstract":"<p><strong>Background: </strong>Prognostic stratification remains suboptimal in unresectable hepatocellular carcinoma (uHCC) treated with locoregional therapy (LRT) plus lenvatinib and PD-1 blockade. Existing staging systems insufficiently reflect host nutritional-immune status.</p><p><strong>Methods: </strong>We included a multicenter retrospective study including 347 patients with uHCC treated with LRT, lenvatinib, and a PD-1 inhibitor. Nine prognostic models were developed using Cox regression Model performance was evaluated using time-dependent AUC (tdAUC), calibration, and decision curve analysis (DCA). A nomogram was constructed for individualized survival prediction.</p><p><strong>Results: </strong>Median overall survival (OS) was 33.1 months (95% CI, 30.5-not reached) and median progression-free survival (PFS) was 10.2 months (95% CI, 9.0-12.6) in the overall cohort. The integrated model (incorporating tumor burden, ALBI grade, AFP, PNI) showed superior discrimination, with C-indices of 0.780 (training cohort) and 0.785 (validation cohort). The tdAUCs for OS and PFS were 0.892 and 0.807, respectively, in the training cohort and 0.861 and 0.819, respectively, in the validation cohort. Calibration plots demonstrated good agreement between predicted and observed 2-year OS in both cohorts. Risk stratification based on tertiles yielded significantly separated survival curves in both cohorts (all P<0.001). The nomogram achieved strong predictive accuracy, with 1-, 2-, and 3-year AUCs of 0.879, 0.808, and 0.787, respectively.</p><p><strong>Conclusion: </strong>PNI-integrated prognostic model provides robust risk stratification for uHCC patients receiving LRT combined with lenvatinib and PD-1 inhibitors, supporting individualized pre-treatment risk assessment.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"626820"},"PeriodicalIF":3.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897069","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":"Balloon-Occluded Transarterial Chemoembolization for Hepatocellular Carcinoma: Technical Rationale, Current Evidence, and Future Directions.","authors":"Xiaoli Jia, Yuanyi Chen, Xiaomeng Cui, Yan Tian, Dandan Feng, Wenjun Wang","doi":"10.2147/JHC.S622393","DOIUrl":"10.2147/JHC.S622393","url":null,"abstract":"<p><p>Balloon-occluded transarterial chemoembolization (B-TACE) uses temporary microballoon occlusion to reduce distal arterial pressure and promote dense, selective deposition of chemoembolic material within the tumor and its drainage territory. Observational comparative studies and a meta-analysis suggest higher complete response and objective response rates than conventional TACE (C-TACE), especially in 3-5 cm tumors. However, randomized evidence and a proven survival advantage are lacking. Clinical benefit is therefore most plausible in carefully selected patients with preserved liver function, a limited tumor burden amenable to segmental treatment, and anatomy in which collateral inflow does not prevent a meaningful pressure reduction. Measurement of balloon-occluded arterial stump pressure may help characterize hemodynamics, but the proposed <64 mmHg threshold is not universally reproducible or routinely available. B-TACE has a broadly comparable overall safety profile to C-TACE, while non-target or excessive peripheral embolization can injure the peribiliary plexus and cause biloma or hepatic abscess. Future priorities include standardized technical endpoints, prospective randomized comparisons, validated selection criteria, imaging-based hemodynamic prediction, and rigorously designed combinations with systemic or other locoregional therapies.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"622393"},"PeriodicalIF":3.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874437","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 Survival Advantage of Prior Curative Hepatectomy in Patients with Hepatocellular Carcinoma Receiving First-Line Multikinase Inhibitors: A Propensity Score-Adjusted Study.","authors":"Jia-Min Wu, Guan-Hua Li, Cheng-Chun Lee, Jie-Ying Chen, Shun-Fa Yang, Kuan-Chun Hsueh","doi":"10.2147/JHC.S620001","DOIUrl":"10.2147/JHC.S620001","url":null,"abstract":"<p><strong>Background: </strong>Curative hepatectomy is the treatment of choice for resectable hepatocellular carcinoma (HCC). For recurrence or progression beyond locoregional therapy (LRT), multikinase inhibitors (MKIs) remain established first-line options. However, whether prior curative resection is associated with a survival benefit after MKI initiation remains unclear. We employed inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) to compare survival in MKI-treated patients with and without prior hepatectomy.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 203 patients with unresectable HCC receiving first-line sorafenib or lenvatinib at a single Taiwanese referral hospital (2018-2023). Patients were classified into recurrent HCC (rHCC, n = 58; with prior curative resection) and primary unresectable HCC (uHCC, n = 145; without prior resection) groups. Overall survival (OS) and progression-free survival (PFS) were evaluated using stabilized IPTW with multivariable Cox regression, and PSM as a sensitivity analysis.</p><p><strong>Results: </strong>Over a 13.2-month median follow-up, median OS was longer in the rHCC group (27.0 vs 11.8 months; P = 0.027). After IPTW adjustment, prior resection was independently associated with longer OS (HR: 0.54; 95% CI: 0.36-0.81; P = 0.003) and PFS (HR: 0.61; 95% CI: 0.42-0.89; P = 0.010). PSM yielded concordant results (OS HR: 0.42; 95% CI: 0.26-0.70; P < 0.001; PFS HR: 0.55; 95% CI: 0.35-0.86; P = 0.010). This survival advantage was primarily observed in patients with late recurrence (≥24 months from hepatectomy). High tumor burden was an independent adverse prognostic factor for OS (HR: 1.58; 95% CI: 1.08-2.30; P = 0.017).</p><p><strong>Conclusion: </strong>In patients receiving first-line MKIs, prior curative resection was associated with longer OS and PFS. The better liver reserve and more favorable tumor biology that made these patients suitable candidates for surgery may persist into the systemic therapy phase. Therefore, future clinical trials might consider prespecifying prior resection as a stratification factor.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"620001"},"PeriodicalIF":3.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874468","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}