Journal of Hepatocellular Carcinoma最新文献

{"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}

{"title":"Efficacy and Safety of Ipilimumab Plus Anti-PD-1/PD-L1 Antibodies Combination Therapy in Advanced Hepatocellular Carcinoma Patients Progressing After Multiple Lines of Treatment: A Retrospective Multicenter Study.","authors":"Su-Su Zheng, Jing-Fang Wu, Zhen-Zhen Zhang, Yan-Fang Wu, Yi-Jie Chen, Sheng Qian, Bo-Heng Zhang","doi":"10.2147/JHC.S512302","DOIUrl":"https://doi.org/10.2147/JHC.S512302","url":null,"abstract":"<p><strong>Background: </strong>The combination of nivolumab and ipilimumab has demonstrated significant antitumor activity in first-line treatment for hepatocellular carcinoma (HCC) and in second-line treatment following progression on sorafenib. However, the efficacy and safety of ipilimumab plus anti-PD-1/PD-L1 antibodies combination therapy in advanced HCC patients who have progressed after multiple lines of treatment have not yet been reported.</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective study that included 33 HCC patients who had progressed after multiple lines of immune-targeted therapy and received ipilimumab combination therapy. All patients had received at least one line of immunotherapy based combination therapy (excluding those treated with anti-CTLA-4 inhibitors). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Efficacy was assessed using RECIST 1.1, while adverse events were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE 5.0).</p><p><strong>Results: </strong>Among the patients, 29 (87.9%) received ipilimumab combination therapy as third-line or later line therapy. The median OS for the entire cohort was 14.07 months (95% CI: 5.57 months - not evaluable), and the median PFS was 2.36 months (95% CI: 1.97-5.64 months). Univariate survival analysis indicated that an NLR ≥ 3.1 and tumor size ≥ 63 mm are prognostic risk factors for OS (P=0.03 and P=0.027, respectively). Multivariate survival analysis revealed that an NLR ≥ 3.1 is the only independent prognostic risk factor for OS (P=0.048). The overall response rate (ORR) was 12.1%, and the disease control rate (DCR) was 48.5%. One patient experienced treatment-related death (3%), two had hyperprogression (6.1%), and three discontinued treatment due to adverse events (9.1%).</p><p><strong>Conclusion: </strong>Ipilimumab combination therapy in very late lines is a viable treatment option, although careful monitoring for adverse events is essential. Earlier application of this combination may potentially benefit patients more effectively.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"527-537"},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649235","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 Diagnostic Performance of AFP, AFP-L3, DCP, CA199, and Their Combination for Primary Liver Cancer.","authors":"Yue Liu, Wenrong Jiang, Xiangxiao Li, Hu Zhao, Shiwen Wang","doi":"10.2147/JHC.S499966","DOIUrl":"10.2147/JHC.S499966","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of primary liver cancer (PLC) is rising, yet strategies for its early diagnosis remain inadequate. This study aims to identify novel biomarkers to improve the diagnostic ability of PLC.</p><p><strong>Patients and methods: </strong>This study included 94 patients with PLC, 128 patients with benign liver disease (BLD), and 79 normal controls (NC) were included. Among the PLC group, there were 39 patients with hepatocellular carcinoma (HCC), 14 patients with intrahepatic cholangiocarcinoma (ICC), 4 patients with combined hepatocellular-cholangiocarcinoma (CHC) and 37 patients with imaging-diagnosed HCC, respectively. Serum biomarkers and other laboratory parameters were collected and analyzed. Diagnostic values of individual and combined biomarkers for PLC were assessed using receiver operating characteristic (ROC) curve analysis. Univariate and multivariate logistic regression identified predictors of PLC, and a nomogram model was developed based on the independent predictors.</p><p><strong>Results: </strong>AFP and DCP levels were significantly higher in the HCC patients compared to those with the BLD. AFP-L3 and CA199 levels were markedly elevated in patients with HCC, ICC, and CHC compared with the other groups. Combining AFP, AFP-L3, DCP, and CA199 increased the AUC to 0.8492 for the PLC group versus the BLD group. Multivariate logistic regression analysis identified sex, AFP-L3, DCP, and CA199 as independent predictors of PLC, and a reliable nomogram model was developed based on these predictors.</p><p><strong>Conclusion: </strong>The combined use of AFP, AFP-L3, DCP, and CA199 significantly enhanced the diagnostic performance of PLC compared with existing models like GALAD (gender, age, AFP, AFP-L3, and DCP), and ASAP (age, sex, AFP, DCP), as well as individual biomarkers.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"513-526"},"PeriodicalIF":4.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597217","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":"Improving Health-Related Quality of Life in Hepatocellular Carcinoma Patients: Key Methodologies for Assessing Patient Reported Outcomes and Intervention Targets.","authors":"Andrew M Moon, Michael D Kappelman, A Sidney Barritt Iv, Donna M Evon, Hanna K Sanoff, Lynne I Wagner","doi":"10.2147/JHC.S347929","DOIUrl":"10.2147/JHC.S347929","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a complex cancer that generally arises in the context of cirrhosis. Patients with HCC have symptom burden and impact on health-related quality of life (HRQOL) resulting from underlying liver disease, HCC, and cancer treatments. Patient-reported outcome (PRO) measures may improve the management of patients with HCC by accurately capturing the patient perspective, informing prognosis, guiding treatment decisions, and supporting symptom based and palliative care. Furthermore, PRO use in HCC research could enhance patient-focused therapy development. This review focuses on the clinical and research assessment of PROs among patients with HCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"497-511"},"PeriodicalIF":4.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597215","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 Changes in Combined Child-Pugh Class and ALBI Grade in Hepatocellular Carcinoma Treated with Transcatheter Intra-Arterial Therapy Plus Targeted Therapy and PD-(L)1 Inhibitors.","authors":"Xiaoyu Huang, Xiaojing Cao, Yaqing Kong, Fan Tang, Tianhao Cong, Xiang Zhou","doi":"10.2147/JHC.S490439","DOIUrl":"10.2147/JHC.S490439","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate liver function changes in hepatocellular carcinoma (HCC) patients treated with transcatheter intra-arterial therapy plus molecular targeted agents and programmed cell death-1 (ligand-1) inhibitors, and evaluate the prognostic significance of the combination of Child-Pugh (CP) class and albumin-bilirubin (ALBI) grade (CP/ALBI).</p><p><strong>Methods: </strong>This is a retrospective study. A total of 149 patients from 2019 to 2023 in China were included. Changes in CP score, ALBI grade, and CP/ALBI grade at 4-8 weeks, 12-16 weeks, and 20-28 weeks post-treatment was evaluated. Cox regression models identified prognostic factors for overall survival (OS) and progression-free survival (PFS). The discrimination of the scoring systems was determined by concordance index (C-index) and time-dependent area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among CP-A patients (n = 137), 11.68% (n = 16) progressed to CP-B by 20-28 weeks (<i>p</i> < 0.001). Multivariate analysis identified CP/ALBI grade at 20-28 weeks as an independent prognostic factor for OS (grade 2 vs grade 1, hazard ratio [HR] 3.12, <i>p</i> < 0.001; grade 3 vs grade 1, HR 4.95, <i>p</i> < 0.001) and at 4-8 weeks for PFS (grade 3 vs grade 1, HR 3.26, <i>p</i> = 0.002). The combination of CP/ALBI grade and baseline clinical prognostic factors (Eastern Cooperative Oncology Group Performance Status, Barcelona Clinic Liver Cancer stage, tumor size) demonstrated superior discrimination for OS (C-index: 0.74-0.77; time-dependent AUC: 0.74-0.92). Baseline factors associated with maintaining CP/ALBI grade 1 in CP-A patients included ALBI grade 1 (odds ratio [OR] 3.09, <i>p</i> = 0.030) and aspartate aminotransferase < 40 U/L (OR 3.35, <i>p</i> = 0.017).</p><p><strong>Conclusion: </strong>A small but notable proportion of HCC patients experienced liver function deterioration within 28-week of combined treatment. Dynamic monitoring of CP/ALBI grade provides valuable prognostic insights for patient stratification.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"481-496"},"PeriodicalIF":4.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584825","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":"Research Progress of Liver Cancer Recurrence Based on Energy Metabolism of Liver Cancer Stem Cells.","authors":"Mingming Wu, Huayu Wang, Xiangxiang Wu, Huahui Zeng, Mingsan Miao, Yagang Song","doi":"10.2147/JHC.S500638","DOIUrl":"10.2147/JHC.S500638","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to investigate the recurrence and progression of liver cancer by focusing on the energy metabolism of liver cancer stem cells.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using databases including CNKI, PubMed, Wanfang, and Citexs to analyze the etiology and treatment of hepatocellular carcinoma (HCC), the factors and mechanisms contributing to HCC recurrence, and the impact of energy metabolism in HCC stem cells on the development of HCC. Furthermore, the association between HCC recurrence and the energy metabolism of HCC stem cells was examined.</p><p><strong>Results: </strong>The primary targets associated with the glycolytic metabolism of HCC stem cells included HK2, PFK, PK, LDH, among others. Glutamine metabolism primarily involves the tricarboxylic acid (TCA) cycle, with main targets such as mTORC1 and reactive oxygen species (ROS). The principal pathway in lipid metabolism is fatty acid (FA) biosynthesis, with key targets being fatty acid synthase (FASN), acetyl-coenzyme A carboxylase (ACC), stearoyl-coenzyme A desaturase-1 (SCD1), and adenosine monophosphate-activated protein kinase (AMPK). Targets in the oxidative phosphorylation pathway include PGC1a. Finally, key targets in iron metabolism encompass System Xc, glutathione peroxidase 4 (GPX4), and DMT1.</p><p><strong>Conclusion: </strong>The glycolytic metabolism of HCC stem cells represents a primary metabolic pathway in HCC stem cells, with key targets including HK2, PFK, PK, and LDH warranting closer attention. Glutamine metabolism should focus on the TCA cycle and targets such as mTORC1 and ROS. Lipid metabolism pathway involves FA biosynthesis, with significant targets being FASN, ACC, SCD1, and AMPK. Iron metabolism, specifically System Xc, GPX4, and DMT1 targets, should be carefully considered. Therefore, interventions for the prevention and treatment of liver cancer recurrence should be directed towards these aspects of liver cancer stem cells.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"467-480"},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585249","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 Case of DEB-TACE Combined with Anlotinib for Treatment of Liver Metastasis from Retroperitoneal Leiomyosarcoma.","authors":"Huiying Cui, Qiang Xu, Zhezhu Han, Songnan Zhang","doi":"10.2147/JHC.S502611","DOIUrl":"10.2147/JHC.S502611","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal soft tissue sarcomas are characterized by a high rate of local recurrence and distal metastases. The optimal treatment for prolonged survival remains unknown.</p><p><strong>Case presentation: </strong>This study reports a patient with leiomyosarcoma (LMS) diagnosed through postoperative recurrence with failed systemic chemotherapy. The patient underwent retroperitoneal tumor resection and surgical pathology showed LMS.A CT scan of the abdomen was performed one year after the surgical procedure, which revealed the presence of multiple intrahepatic metastases. Two cycles of systemic chemotherapy with a combination of doxorubicin and ifosfamide were performed, after which imaging assessment showed the intrahepatic lesions were significantly enlarged compared to prior ones. Considering the failure of systemic chemotherapy, the patient was treated with drug-eluting bead transarterial chemoembolization (DEB-TACE) eight times with simultaneous targeted therapy with anlotinib, and the disease control time reached 29 months.</p><p><strong>Conclusion: </strong>This case provides a new treatment option for patients with multiple liver metastases from retroperitoneal leiomyosarcoma, which is discussed in the context of this case.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"459-465"},"PeriodicalIF":4.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Transarterial Chemoembolization Combined with Hepatic Arterial Infusion Chemotherapy Plus Lenvatinib for Intermediate-Stage Hepatocellular Carcinoma Beyond Up-To-Seven: A Multicentre, Retrospective Propensity Score Matching Analysis.","authors":"Sheng Zhong, Fengtao Zhang, Haiming Zhang, Honglei Hu, Quan Zeng, Yangyang Li, Qiming Wei","doi":"10.2147/JHC.S506457","DOIUrl":"10.2147/JHC.S506457","url":null,"abstract":"<p><strong>Background: </strong>Previous LAUNCH trial revealed the promising effectiveness of transarterial chemoembolization (TACE) combined with lenvatinib for advanced hepatocellular carcinoma (HCC). However, most intermediate-stage HCC exceeds the up-to-seven criteria, limiting their potential TACE benefits. Hepatic arterial infusion chemotherapy (HAIC) was widely endorsed for delivering substantial survival benefits for high tumor burden HCC, outperforming TACE. Accordingly, we undertook this study to evaluate the efficacy and safety of TACE combined with HAIC plus lenvatinib for intermediate-stage HCC beyond up-to-seven criteria.</p><p><strong>Methods: </strong>From June 2017 to November 2021, clinical data of intermediate-stage HCC patients beyond up-to-seven criteria received TACE combined with HAIC plus lenvatinib or TACE alone from four medical centers in China were retrospectively collected. Propensity score matching (PSM) and inverse probability weighting (IPTW) were applied to balance baseline differences. The Kaplan-Meier method was utilized for survival analysis. Cox regression-based multivariate analysis was used to identify survival-related risk factors. We compare tumor response and the incidence of adverse reactions between groups.</p><p><strong>Results: </strong>A total of 294 intermediate-stage HCC patients beyond up-to-seven criteria received TACE combined with HAIC plus lenvatinib (the TACEHL group, n = 127) or TACE monotherapy (the TACE group, n = 167) were finally enrolled. Following propensity matching, the median OS and median PFS in the TACEHL group were 34.6 months and 15.7 months, respectively, significantly higher than the 15.7 months and 6.9 months observed in the TACE group. In tumor response, the ORR was 71.4% in the TACEHL group and 30.8% in the TACE group (P < 0.001), the DCR was 92.3% in the TACEHL group and 75.8% in the TACE group (P = 0.005). The 3-4 grade adverse reactions were comparable between the groups.</p><p><strong>Conclusion: </strong>For intermediate-stage HCC beyond up-to-seven criteria, the integration of TACE and HAIC plus lenvatinib therapy demonstrated substantial enhancements in survival prognosis, which is a promising treatment regimen.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"445-458"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567266","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":"Increment of Skeletal Muscle Mass Predicts Survival Benefit for Hepatocellular Carcinoma Treated with Transarterial Chemoembolization Combining Molecular Targeted Agents and Immune Checkpoint Inhibitors.","authors":"Wen Chen, Hai-Tao Yan, Jin-Xing Zhang, Xiao Shen, Jin Liu, Sheng Liu, Hai-Bin Shi, Ye Ding, Qing-Quan Zu","doi":"10.2147/JHC.S506412","DOIUrl":"10.2147/JHC.S506412","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the relationship between clinical prognosis and changes of skeletal muscle mass for unresectable hepatocellular carcinoma (uHCC) patients who received transarterial chemoembolization (TACE) with molecular-targeted agents and immune checkpoint inhibitors (TACE-MTAs-ICIs).</p><p><strong>Methods: </strong>From June 2019 to June 2023, a total of 92 uHCC patients who received TACE-MTAs-ICIs therapy were included. Skeletal muscle mass was assessed before and 6 months after treatment. Skeletal muscle index (SMI) is calculated as skeletal muscle area at the L3 vertebra divided by the square of height, then the change rate of SMI (ΔSMI) is calculated. Patients were stratified based on ΔSMI as muscle gain and non-muscle gain groups. Overall survival (OS) was compared between groups and prognostic factors for OS were analyzed. Progression-free survival (PFS) was also recorded.</p><p><strong>Results: </strong>The median OS in the muscle gain group was significantly longer than that in the non-muscle gain group (Not reach vs 25.2 months, <i>P</i> < 0.001). The median PFS did not reach significant between two groups (16.2 vs 9.1 months, <i>P</i> = 0.101). Multivariate analyses revealed that skeletal muscle gain (HR = 0.20; 95% CI, 0.06-0.68; <i>P</i> = 0.010) and Barcelona Clinic Liver Cancer stage (HR = 1.94; 95% CI, 1.02-3.69; <i>P</i> = 0.044) were independent prognostic factors for OS.</p><p><strong>Conclusion: </strong>SMI increment appeared as a favorable predictor for these uHCC patients who received TACE-MTAs-ICIs therapy.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"415-426"},"PeriodicalIF":4.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542228","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}