Journal of Hepatocellular Carcinoma最新文献

{"title":"MRI Radiomics to Predict Early Treatment Response to TACE Combined with Lenvatinib Plus a PD-1 Inhibitor for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.","authors":"Deyu Lu, Lingling Zhou, Ziyi Zuo, Zhao Zhang, Xiangwu Zheng, Jialu Weng, Zhijie Yu, Jiansong Ji, Jinglin Xia","doi":"10.2147/JHC.S513696","DOIUrl":"10.2147/JHC.S513696","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a predictor for early treatment response in hepatocellular carcinoma (HCC) patients accompanied by portal vein tumor thrombus (PVTT) undergoing transarterial chemoembolization (TACE), lenvatinib and a programmed cell death protein 1 (PD-1) inhibitor (TLP) therapy.</p><p><strong>Patients and methods: </strong>In this retrospective study, patients with HCC and PVTT from two institutions receiving triple TLP therapy were enrolled. Radiomics features derived from pretreatment contrast-enhanced MRI were curated using intraclass correlation coefficient (ICC), Student's <i>t</i>-test, least absolute shrinkage and selection operator (LASSO), and recursive feature elimination (RFE) to ensure robust selection. Various machine learning (ML) algorithms were then used to construct the models. The meaningful clinical indicators were obtained via logistic regression analysis and ultimately integrated with radiomics features to develop a combined model. In addition, we used Shapley Additive exPlanation (SHAP) to clarify the model's operational dynamics.</p><p><strong>Results: </strong>Our study ultimately included 115 patients (7:3 randomization, 80 and 35 in the training and test cohorts, respectively) in total. No patients achieved complete remission, 47 achieved partial remission, 29 achieved stable disease, and 39 experienced disease progression. Among objective response rates (ORRs) and disease control rates (DCRs), 40.9% and 66.1% were reported. One of the four ML classifiers with optimal performance, namely random forest, was adopted as the radiomics model after testing. Regarding the performance assessment, the radiomics model's area under the curve (AUC) values reached 0.92 (95% CI: 0.86-0.97) and 0.79 (95% CI: 0.61-0.95), inferior to the combined model's AUCs of 0.95 (95% CI: 0.68-0.98) and 0.84 (95% CI: 0.91-0.99). Moreover, the SHAP plots illustrate the importance of global variables and the prediction process for individual samples.</p><p><strong>Conclusion: </strong>The model based on machine learning and radiomics showed favorable performance, and the operating mode was visualized through SHAP.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"985-998"},"PeriodicalIF":4.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127807","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 Real-World Prevalence of Esophagogastric Varices, Bleeding, Emergency Room Visits, and Hospitalization Among Patients with Advanced Hepatocellular Carcinoma in the United States: A Retrospective Cohort Study.","authors":"Neehar D Parikh, Noh Jin Park, Michael Locker, Ishveen Chopra, Jason Yeaw, Shengsheng Yu","doi":"10.2147/JHC.S496618","DOIUrl":"10.2147/JHC.S496618","url":null,"abstract":"<p><strong>Purpose: </strong>Esophagogastric varices (EGV) and upper gastrointestinal bleeding are common and potentially fatal complications in patients with advanced hepatocellular carcinoma (aHCC). We aimed to evaluate the real-world prevalence of EGV among the aHCC population in the United States.</p><p><strong>Patients and methods: </strong>This retrospective cohort study utilized IQVIA's PharMetrics Plus Health Plans Claims database between January 1, 2016, and July 31, 2021 (study period). Adult patients with an aHCC diagnosis who initiated systemic therapies were included, while those with any secondary malignancies or prior liver transplant at baseline were excluded. The date of therapy initiation was the index date; baseline characteristics, prior procedures, and clinical events of interest were captured during the 12-month pre-index (baseline) period. Patients were followed for clinical outcomes (EGV- or bleeding-related emergency room [ER] visits or hospitalization) during the 6-month post-index period. Logistic regression was conducted to identify key predictors of post-index EGV- or bleeding-related ER visit or hospitalization.</p><p><strong>Results: </strong>904 patients with aHCC were included in the study (mean age: 61.3 years; 75.3% male). Sorafenib (423 patients, 46.8%) was the most prescribed aHCC treatment. During the entire study period, 458 patients (50.7%) underwent an esophagogastroduodenoscopy (EGD), of whom 209 (45.6%) had post-index EGV. Among 327 patients (36.2%) with a baseline EGD, 175 (53.5%) were diagnosed with EGV and 50 (15.3%) had variceal bleeding; 141 patients (15.6% of all patients) experienced ≥1 EGV- or bleeding-related ER visit or hospitalization post-index.</p><p><strong>Conclusion: </strong>There is a high prevalence of EGV in patients with aHCC. The presence of EGV, gastrointestinal bleeding, and portal hypertension-related comorbidities was associated with an increased risk of subsequent EGV- or bleeding-related ER visits or hospitalizations in patients with aHCC. Assessment and stratification of varices should be considered in patients with aHCC before initiating systemic therapies to inform treatment decisions.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"961-972"},"PeriodicalIF":4.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101945","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":"Atezolizumab Plus Bevacizumab Combined with or without Transarterial Chemoembolization in the Treatment of Advanced Hepatocellular Carcinoma: A Single-Center Retrospective Study.","authors":"Jing Li, Yaowei Bai, Fu Xiong, Xiaocui Liu, Junwen Hu, Guilin Zhang, Jiayun Liu, Suyue Wu, Chuansheng Zheng, Xuefeng Kan","doi":"10.2147/JHC.S515453","DOIUrl":"10.2147/JHC.S515453","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the efficacy and safety of atezolizumab plus bevacizumab (T+A) in combination with transarterial chemoembolization (TACE) (T+A+TACE) and T+A for patients with advanced hepatocellular carcinoma (HCC).</p><p><strong>Patients and methods: </strong>From December 2020 to August 2024, 83 patients with advanced HCC who received T+A+TACE treatment or T+A treatment in our hospital were included, and these patients were categorized into TACE+T+A group (n=52) and T+A group (n=31). The clinical outcomes between the two groups were analyzed and compared, and the prognostic factors that affected the efficacy were analyzed.</p><p><strong>Results: </strong>The median overall survival (OS) and median progression-free survival (PFS) in the T+A+TACE group were significantly longer than those of in the T+A group (OS: 22.8 vs 16.9 months, <i>P</i> = 0.015; PFS: 7.1 vs 4.9 months, <i>P</i> = 0.006). A significantly higher objective response rate (ORR) and disease control rate (DCR) that are based on the modified RECIST were achieved in the T+A+TACE group than those of in the T+A group (ORR: 51.9% vs 6.5%, <i>P</i> < 0.001; DCR: 88.5% vs 54.8%, <i>P</i> < 0.001). No significant differences in adverse events (AEs) were observed between the two groups (<i>P</i> > 0.05). The T+A+TACE treatment was identified as a protective factor for OS and PFS.</p><p><strong>Conclusion: </strong>TACE further improved the efficacy of T+A treatment for patients with advanced HCC, and it did not increase the incidence of AEs. T+A+TACE treatment is a promising treatment option for patients with advanced HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"973-984"},"PeriodicalIF":4.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110966","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":"Can Intra-Operative Ablation-Specific Features Based on Ultrasound Fusion Imaging be Used to Predict Early Recurrence of Hepatocellular Carcinoma After Microwave Ablation: A Proof-of-Concept Study.","authors":"Haiyu Kang, Zhong Liu, Bin Huang, Shuang Liang, Kai Yang, Huahui Liu, Minhua Lu, Ronghua Yan, Xin Chen, Erjiao Xu","doi":"10.2147/JHC.S512926","DOIUrl":"10.2147/JHC.S512926","url":null,"abstract":"<p><strong>Purpose: </strong>Intra-operative factors are crucial to early recurrence of hepatocellular carcinoma (HCC) after microwave ablation (MWA), but few models have been developed based on intra-operative data to predict HCC recurrence after MWA. To quantify the intra-operative factors associated with MWA and establish an artificial intelligence (AI) model for predicting early recurrence of HCC after ablation based on contrast-enhanced ultrasound (CEUS) fusion imaging.</p><p><strong>Patients and methods: </strong>79 hCC patients, who underwent MWA with one-year follow-up and intraoperative CEUS fusion imaging assessment were retrospectively included. Three classifiers (support vector machine (SVM), random forest (RF), and multilayer perceptron (MLP)) were developed to predict early HCC recurrence from CEUS fusion images. Thirteen ablation-specific features were defined and screened using minimum redundancy maximum relevance (mRMR), and leave-one-out cross-validation (LOOCV) was adopted for performance evaluation. Comparative analyses were conducted among classifiers and between a senior interventional doctor and the best classifier in terms of the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Of 79 eligible patients who were included, 22 were in the early-recurrence (age 60.18 ± 10.97; 20 males) and 57 were in the non-early recurrence (age 58.81 ± 10.89; 50 males). Six features were selected out by mRMR for early recurrence prediction and AUCs of three models were 0.84 (95% CI: 0.74, 0.94) 0.79 (95% CI: 0.69, 0.89) and 0.77 (95% CI: 0.67, 0.88) (p = 0.20 and 0.23 for SVM and RF, respectively), which was significantly better than that achieved by senior doctor's assessment (AUC, 0.56; 95% CI: 0.44, 0.68; p = 0.002 for MLP).</p><p><strong>Conclusion: </strong>The prediction model based on ablation-specific features using intra-operative ultrasound fusion imaging data was feasible to predict early recurrence of HCC after MWA and showed great potential in guiding the real-time adjustment of the intra-operative ablation strategy so as to achieve precise ablation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"949-960"},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093960","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":"Decoding ARF4 and EIF5B-Based Prognostic Signatures and Immune Landscape Following Insufficient Radiofrequency Ablation in Hepatocellular Carcinoma: Through Multi-Omics and Experimental Validation.","authors":"Yixin Zhang, Yongpan Lu, Sui Zheng, Wanrong Luo, Min Tan, Baoming Luo","doi":"10.2147/JHC.S517528","DOIUrl":"https://doi.org/10.2147/JHC.S517528","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) is pivotal in non-surgical hepatocellular carcinoma (HCC) treatments but poses a high postoperative recurrence risk, exceeding conventional surgeries. Insufficient tumor ablation may trigger immune responses, promoting tumor progression locally. Hence, this study seeks to pinpoint immune biomarkers to improve treatment precision and prognostic accuracy for RFA patients.</p><p><strong>Methods: </strong>The study utilized data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and The International Cancer Genome Consortium (ICGC) database to investigate novel immune biomarkers influencing the prognosis of patients undergoing insufficient radiofrequency ablation (IRFA). Subsequently, an IRFA model was developed and validated. Then, we employed Quantitative real time-Polymerase Chain Reaction (qPCR), Western blotting (WB), immunohistochemistry (IHC), and immunofluorescence (IF) techniques on human HCC cell lines and IRFA animal model to validate ADP-ribosylation factor 4 (ARF4) and Eukaryotic translation initiation factor 5B (EIF5B) expression and prognostic relevance post-IRFA. In addition, knockdown of ARF4 and EIF5B was performed to evaluate cell proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT). Finally, transcriptome sequencing was subsequently performed to confirm and extend our findings.</p><p><strong>Results: </strong>ARF4 and EIF5B were identified as critical immune targets affecting IRFA patient prognosis, forming the basis of an IRFA risk model. High-risk scores in this model correlated with poorer prognoses and reduced responsiveness to immune checkpoint inhibitors (ICIs) across multiple cancer types. Experimental validations confirmed the protective role of ARF4 and EIF5B in IRFA outcomes, while knockdown experiments suggested their involvement in promoting cell proliferation, migration, invasion, and EMT in IRFA models, potentially through pathways like P53 and Transforming Growth Factor Beta(TGF-β) signaling pathway activation as indicated by transcriptome sequencing.</p><p><strong>Conclusion: </strong>ARF4 and EIF5B have demonstrated promising potential as biomarkers influencing patient prognosis following RFA in HCC. These findings suggest they could serve as viable therapeutic targets aimed at mitigating HCC recurrence post-RFA.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"909-931"},"PeriodicalIF":4.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078445","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 Radiomics for Predicting Response to MR-Guided Radiotherapy in Unresectable Hepatocellular Carcinoma: A Multicenter Cohort Study.","authors":"Ke Su, Xin Liu, Yue-Can Zeng, Junnv Xu, Han Li, Heran Wang, Shanshan Du, Huadong Wang, Jinbo Yue, Yong Yin, Zhenjiang Li","doi":"10.2147/JHC.S521378","DOIUrl":"https://doi.org/10.2147/JHC.S521378","url":null,"abstract":"<p><strong>Background: </strong>This study was conducted to assess the efficacy and safety of magnetic resonance (MR)-guided hypofractionated radiotherapy in patients with unresectable hepatocellular carcinoma (HCC). Machine learning-based radiomics was utilized to predict responses in these patients.</p><p><strong>Methods: </strong>This retrospective study included 118 hCC patients who received MR-guided hypofractionated radiotherapy. The primary study endpoint was the objective response rate (ORR). Radiomics features were based on the gross tumor volume (GTV). K-means clustering was performed to differentiate cancer subtypes based on radiomics. Nine radiomics-utilizing machine learning models were built and validated internally through 5-fold cross-validation.</p><p><strong>Results: </strong>The ORR, median progression-free survival (mPFS), and median overall survival (mOS) were 54.4%, 21.7 months, and 40.7 months, respectively. No patient experienced Grade 3/4 adverse events. 1130 radiomics features were extracted from the GTV, of which 7 were included for further analysis. K-means clustering identified 2 subtypes based on the selected features. Subtype 1 had significantly higher response, longer mPFS, and longer mOS than Subtype 2. In both internal and external validations, the multi-layer perceptron (MLP) model demonstrated superior predictive performance for response, achieving a receiver operating characteristic-area under the curve (ROC-AUC) of 0.804 and 0.842, respectively.</p><p><strong>Conclusion: </strong>MR-guided radiotherapy was proven to be effective and safe for HCC. The machine learning radiomics model developed in this study could accurately predict the response of radiotherapy-treated inoperable HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"933-947"},"PeriodicalIF":4.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078447","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":"NRF1-Induced lncRNA DDX11-AS1 Contributes to the Progression of Hepatocellular Carcinoma via Activating CA9 Expression and the MEK/ERK Pathway.","authors":"Yingnan Li, Mengjiao Shi, Beibei Bie, Hongwei Tian, Jun Li, Zongfang Li, Jin Sun","doi":"10.2147/JHC.S516656","DOIUrl":"https://doi.org/10.2147/JHC.S516656","url":null,"abstract":"<p><strong>Purpose: </strong>DDX11 antisense RNA 1 (DDX11-AS1) has been recognized for its strong correlation with hepatocellular carcinoma (HCC). Nevertheless, the exact biological functions and fundamental molecular processes of DDX11-AS1 in HCC require further in-depth investigation.</p><p><strong>Methods: </strong>A comprehensive bioinformatics analysis was carried out to explore the expression of DDX11-AS1 and its clinical implication in HCC utilizing the TCGA data. qRT-PCR was employed to validate the expression of DDX11-AS1 in HCC tissues/cell lines. RNA fluorescence in situ hybridization (RNA-FISH) was used to observe the subcellular localization of DDX11-AS1 in HCC cells. Loss-of-function experiments, both in vitro and in vivo, were executed to elucidate the biological functions of DDX11-AS1 in HCC. RNA sequencing (RNA-seq) was employed to identify genes and signaling pathways potentially regulated by DDX11-AS1. Rescue experiments were conducted to validate that carbonic anhydrase IX (CA9) mediates DDX11-AS1 promoting HCC progression. The influence of nuclear respiratory factor 1 (NRF1) on the transcription of DDX11-AS1 was investigated through dual-luciferase reporter assays and ChIP-qPCR.</p><p><strong>Results: </strong>The increased expression of DDX11-AS1 is positively associated with several aggressive clinical characteristics (pathologic T stage, histologic grade, AFP level, and vascular invasion), and is closely linked to unfavorable outcomes in HCC patients, acting as a separate hazardous factor for overall survival. DDX11-AS1 is predominantly situated in the nucleus of HCC cells. DDX11-AS1 knockdown impeded the growth, migration, and invasion capabilities of HCC cells in vitro, and reduced the tumor enlargement in a subcutaneous mouse model. RNA-Seq unveiled that silencing DDX11-AS1 lessened the expression of CA9 and suppressed the activity of the MEK/ERK signaling cascade in HCC cells. Rescue experiments uncovered that CA9 acts as a downstream target facilitating the cancer-causing roles of DDX11-AS1 in HCC. Furthermore, DDX11-AS1 was revealed to be transcriptionally regulated by NRF1.</p><p><strong>Conclusion: </strong>DDX11-AS1, a NRF1-induced lncRNA, facilitates HCC development by upregulating CA9 expression and activating the MEK/ERK signaling cascade.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"891-908"},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969928","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":"Effectiveness of Minimally Invasive Hepatectomy in Patients with Early or Intermediate-Stage Hepatocellular Carcinoma: A Multi-Institutional Cohort Study in an Asian Population.","authors":"Hung-Kai Chen, Kai-Cheng Chang, Shih-Chieh Shao, Ruey-Shyang Soong, Yi-Chan Chen, Chun-Feng Wu, Tsung-Han Wu, Tien-Shin Chou, Siu-Cheung Chan, Edward Chia-Cheng Lai","doi":"10.2147/JHC.S485171","DOIUrl":"https://doi.org/10.2147/JHC.S485171","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive hepatectomy (MIH) has been increasingly applied for patients with hepatocellular carcinoma (HCC). However, the effectiveness of MIH has yet to be well established.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included patients aged 20 years and older, newly receiving MIH for HCC with Barcelona Clinic Liver Cancer (BCLC) classification stage 0, A or B from 2010 to 2019. Two 1:1 propensity score-matched cohorts of those receiving open hepatectomy (OH) and those receiving radiofrequency ablation (RFA) were selected as comparison groups. As a control analysis, we compared patients receiving OH with those receiving RFA under the hypothesis that the OH group had better survival outcomes than the RFA group.</p><p><strong>Results: </strong>We included a total of 555 matched patients receiving MIH or OH, and 382 matched patients receiving MIH or RFA. Compared to the OH group, MIH group was associated with better overall survival (OS) (Hazard ratios (HR): 0.62; 95% CI: 0.43-0.88) and similar PFS (HR: 0.92; 0.74-1.16). Compared to the RFA group, we found the MIH group was associated with better OS (0.46; 0.32-0.67) and better PFS (0.48; 0.38-0.61). We found consistent results from a series of subgroup analyses (eg, age groups, BCLC stages and hospital levels) and sensitivity analyses (eg, study period restricted to the most recent 5 years (2015-2019)). The control analysis (OH group vs RFA group) confirmed the robustness of main analyses.</p><p><strong>Conclusion: </strong>Our study suggested that MIH had better survival outcomes for patients with early or resectable intermediate-stage HCC, compared to RFA or OH.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"879-890"},"PeriodicalIF":4.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974678","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":"Post-TACE ALBI-Score Trajectory in Intermediate and Advanced Hepatocellular Carcinoma: Prognostic Implications and Influencing Factors Analysis.","authors":"Jian Li, Tianyuyi Feng, Chi Cui, Haochen Wang, Tianhao Su, Long Jin, Xiaohu Zhao, Weizhong Xiao","doi":"10.2147/JHC.S503581","DOIUrl":"https://doi.org/10.2147/JHC.S503581","url":null,"abstract":"<p><strong>Objective: </strong>The long-term effects of transarterial chemoembolization (TACE) on liver function and their prognostic implications in hepatocellular carcinoma (HCC) have not been fully explored. The Albumin-Bilirubin (ALBI) score, an objective measure of liver function, is a validated prognostic tool in HCC. This study aims to characterize the longitudinal trajectories of ALBI-scores after TACE, evaluate their impact on clinical outcomes, and identify factors influencing these trajectories.</p><p><strong>Materials and methods: </strong>This retrospective study included patients with BCLC stage B/C HCC who underwent TACE, with baseline and at least two post-TACE ALBI-score measurements. Group-Based Trajectory Modeling (GBTM) was used to identify distinct ALBI-score trajectories. Clinical outcomes and patient characteristics were compared across trajectory groups. A CatBoost-based clinical prediction model was developed to identify factors influencing ALBI-score trajectories, with Shapley Additive Explanations (SHAP) values providing feature importance interpretation.</p><p><strong>Results: </strong>Among 501 patients, three ALBI-score trajectories were identified: improve, stable, and decline. The improve group had better overall survival (OS) and progression-free survival (PFS) compared to the stable and decline groups. Multivariate analysis confirmed that ALBI-score trajectories were independent risk factors for OS. Subgroup analysis suggested that TACE plus systemic therapy reduced mortality risk in the stable and decline groups. The CatBoost model effectively distinguished distinct trajectory groups, with SHAP analysis highlighting ALBI-grade, Child-Pugh class, and tumor number as key predictors.</p><p><strong>Conclusion: </strong>Post-TACE ALBI-score trajectories are closely linked to clinical outcomes, with improved liver function associated with better prognosis. Monitoring these trajectories could guide personalized treatment strategies for HCC patients undergoing TACE.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"865-878"},"PeriodicalIF":4.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011102","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 Significance of Elevated Platelet Count (>200 x 10^9 per L) in BCLC Stages B and C of Hepatocellular Carcinoma: A Retrospective Multicenter Analysis.","authors":"Stefan Munker, Isaac Rodriguez, Kathrin Bernhart, Najib Ben Khaled, Merve Findik, Lisa Katrin Siegmund, Liangtao Ye, Florian P Reiter, Daniel Roessler, Daniel Nasseh, Lorenz Balcar, Katharina Pomej, Bernhard Scheiner, Christel Weiss, Matthias Pinter, Max Seidensticker, Julia Mayerle, Alexander B Philipp, Enrico N De Toni","doi":"10.2147/JHC.S511263","DOIUrl":"https://doi.org/10.2147/JHC.S511263","url":null,"abstract":"<p><strong>Introduction: </strong>In hepatocellular carcinoma (HCC) comorbidities related to decreased liver function or to portal hypertension often limit treatment options. Traditionally, low platelet count has been considered a negative prognostic factor in HCC, especially in early stages. However, recent evidence suggests that elevated platelet count may also predict worse outcomes in advanced stages, suggesting a stage-dependent prognostic impact.</p><p><strong>Aim: </strong>This study evaluated the prognostic role of platelet counts across BCLC stages, adjusted for portal hypertension, to improve individualized patient management.</p><p><strong>Methods: </strong>In this retrospective, multicenter study, platelet count of 1112 patients with HCC in different tumor stages was analyzed. Various platelet count cutoffs (X to Y × 10^9/L) were tested to identify the optimal prognostic threshold. To isolate the effect of platelet levels from portal hypertension, spleen diameter was incorporated as an adjustment variable in multivariate analyses, with variceal status considered when available (in about two thirds of patients). Using an optimized cut-off, survival analysis was performed using univariate and multivariate Cox proportional hazards models. Bootstrapping was performed for internal validation.</p><p><strong>Results: </strong>Platelet count outside 84-200 × 10^9/L was associated with poorer survival (HR = 0.66, 95% CI = 0.57-0.78, p < 0.0001). Bootstrapping showed robustness of the final model. Subgroup analysis revealed worse survival in BCLC stages B and C but not stage A for elevated platelet counts (>200 × 10^9/L) in multivariate analysis (including spleen diameter).</p><p><strong>Conclusion: </strong>Platelet counts showed a stage-dependent prognostic impact in HCC. A platelet count above a cutoff of 200/µL at diagnosis was associated with poorer prognosis. Using this cutoff may improve survival prediction in BCLC B and C patients with potential usage for risk stratification and guidance of treatment decisions. Further external validation is required to confirm these findings and evaluate their clinical applicability.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"855-864"},"PeriodicalIF":4.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983236","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}