Journal of Hepatocellular Carcinoma最新文献

{"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}

{"title":"Real-World Study of Post-Recurrence Treatment Strategies for Microvascular Invasion-Positive Hepatocellular Carcinoma After Curative Resection.","authors":"Xiao Liu, Xiaokun Chen, Ziyue Huang, Taifeng Zhu, Shunda Du","doi":"10.2147/JHC.S616238","DOIUrl":"https://doi.org/10.2147/JHC.S616238","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal treatment for recurrent hepatocellular carcinoma (HCC) after curative resection remains unclear, particularly in patients with microvascular invasion (MVI). This study evaluated post-recurrence treatment patterns and survival outcomes in this population.</p><p><strong>Methods: </strong>We retrospectively included patients with MVI-positive HCC who developed recurrence after curative hepatectomy at a single center. Post-recurrence progression-free survival (PFS) was the primary endpoint and overall survival (OS) was the secondary endpoint. Kaplan-Meier analysis was used to compare survival across post-recurrence treatment groups. Cox regression, subgroup analysis, propensity score matching, and correlation analysis between recurrence-free survival (RFS) and post-recurrence PFS were also performed.</p><p><strong>Results: </strong>A total of 150 patients were included, and 132 received post-recurrence treatment. Treatment strategies were heterogeneous, with locoregional therapy plus tyrosine kinase inhibitor (TKI) and immune checkpoint inhibitor (ICI), surgery-based therapy, locoregional therapy plus TKI, and locoregional therapy alone being the main approaches. Median PFS and OS were 10.4 and 26.7 months, respectively. Survival outcomes differed across treatment groups in the unadjusted analysis. Patients receiving surgery-based therapy showed more favorable PFS and OS than those receiving locoregional therapy alone, although this finding should be interpreted cautiously given the non-randomized treatment allocation and potential baseline imbalances among treatment groups. In exploratory multivariable analysis, locoregional therapy plus TKI, locoregional therapy plus TKI and ICI, and surgery-based therapy were associated with longer PFS, whereas no treatment regimen was independently associated with OS. Among patients with potentially resectable recurrence, surgery-based therapy showed numerically more favorable outcomes before matching. However, the differences were not statistically significant and became less apparent after propensity score matching.</p><p><strong>Conclusion: </strong>Post-recurrence management in MVI-positive HCC after curative resection was highly heterogeneous. Surgery-based therapy was associated with favorable outcomes in selected patients, but this association may have been influenced by recurrence pattern and patient selection. Locoregional therapy combined with systemic treatment may be considered a clinically relevant option for non-surgical candidates, although its comparative effectiveness requires further validation.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"616238"},"PeriodicalIF":3.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794115","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":"Transformer-Based Habitat Fusion Model Using DCE-MRI Predicts Microvascular Invasion and Recurrence in Hepatocellular Carcinoma.","authors":"Fei Jia, Baolin Wu, Jingqi Jiang, Zhuo Wang, Yuping Han, Jinrui Liu, Mingsong Tang, Xuelian Zhao, Yanli Jiang, Jing Zhang","doi":"10.2147/JHC.S615663","DOIUrl":"https://doi.org/10.2147/JHC.S615663","url":null,"abstract":"<p><strong>Background: </strong>Microvascular invasion (MVI) is the primary risk factor driving recurrence and metastasis of hepatocellular carcinoma (HCC) after surgical treatment. We developed a fusion model integrating dynamic contrast-enhanced MRI (DCE-MRI)-derived habitat radiomics and conventional radiomics with clinical features to preoperatively predict MVI status and recurrence-free survival (RFS).</p><p><strong>Methods: </strong>This study included 193 HCC patients from two centers. Logistic regression analysis was used to identify the independent clinical predictors of MVI. Additionally, habitat radiomics and conventional radiomics were derived from the DCE-MRI data. A transformer deep-learning model was used to integrate multimodal habitat features. Subsequently, a habitat model, a radiomics model and a clinical model were constructed. These models were then integrated into different fusion models. The performance of the single and fusion models was evaluated using different metrics, and the RFS was assessed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>Multivariate analysis identified pseudocapsule integrity and tumor diameter as independent clinical predictors of MVI. Transformer outperformed traditional machine learning methods in fusing multimodal habitat features. A fusion model integrating habitat radiomics, conventional radiomics and clinical predictors demonstrated the best performance (training data: area under the curve [AUC] = 0.950, 95% confidence interval [CI]: 0.918-0.981; testing data: AUC = 0.923, 95% CI: 0.858-0.988) for predicting MVI, with robust calibration and satisfactory clinical utility. Kaplan-Meier analysis confirmed significant RFS stratification for both MVI-positive (<i>p</i> = 0.038) and high-risk nomogram groups (<i>p</i> = 0.033).</p><p><strong>Conclusion: </strong>A fusion model integrating DCE-MRI-based habitat radiomics and conventional radiomics with clinical features provides excellent prediction of MVI (AUC = 0.923) and RFS in patients with HCC. This model may provide important support for optimized surgical planning and personalized therapy.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"615663"},"PeriodicalIF":3.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794038","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":"Neoadjuvant Hepatic Arterial Infusion Chemotherapy with FOLFOX Plus Tislelizumab for Resectable Hepatocellular Carcinoma Beyond the Milan Criteria: Efficacy, Safety and Biomarker Exploration.","authors":"Quanwei Dai, Huiting Deng, Jun Wang, Jingxiang Shi, Jianmin Ding, Yanying Gao, Wei Sun, Yunzhi Shen, Ximo Wang, Cheng Lou","doi":"10.2147/JHC.S615120","DOIUrl":"10.2147/JHC.S615120","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy and safety of hepatic arterial infusion chemotherapy of oxaliplatin, fluorouracil, and leucovorin (FOLFOX-HAIC) combined with tislelizumab as a neoadjuvant regimen in patients with resectable hepatocellular carcinoma (HCC) beyond the Milan criteria, and to explore predictive biomarkers of treatment response.</p><p><strong>Results: </strong>26 patients completed neoadjuvant therapy, with a median tumor size of 6.35cm. The objective response rate according to mRECIST criteria reached 57.7%, and the disease control rate was 96.2%. 22 patients underwent radical surgery, and 10 patients (10/22, 45.5%) achieved major pathological response (residual viable tumor ≤10%). Six patients (27.3%) achieved complete pathological response, and 25 patients (96.2%) experienced at least one treatment-related adverse events (TRAEs) The most common TRAEs were elevated transaminases (76.9%), HAIC-related pain (34.6%). Transcriptomic analysis revealed that differential genes between responding and non-responding tumors primarily involved pathways related to bile acid secretion and fatty acid metabolism. Metabolomic analysis showed elevated serum chenodeoxycholic acid (CDCA) in non-responders and elevated tumor glycocholic acid (GCA). Microbiome analysis further confirmed increased abundance of bile acid metabolism-related bacteria such as bacteroides in non-responders. Serum interleukin-6 (IL-6) levels after neoadjuvant therapy were correlated with treatment response.</p><p><strong>Conclusion: </strong>FOLFOX-HAIC combined with tislelizumab as neoadjuvant therapy for HCC beyond the Milan criteria demonstrates favorable anti-tumor efficacy and controllable toxicity. The level of GCA in tumor, peripheral blood CDCA, IL-6, and fecal bacteroides may hold the potential to serve as a composite biomarker panel to predict pathological response and treatment sensitivity.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"13 ","pages":"615120"},"PeriodicalIF":3.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758445","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}