Liver Cancer最新文献

{"title":"Chinese Expert Consensus on the Whole-Course Management of Hepatocellular Carcinoma (2023 Edition).","authors":"Yu Yang, Juxian Sun, Jianqiang Cai, Minshan Chen, Chaoliu Dai, Tianfu Wen, Jinglin Xia, Mingang Ying, Zhiwei Zhang, Xuewen Zhang, Chihua Fang, Feng Shen, Ping An, Qingxian Cai, Jingyu Cao, Zhen Zeng, Gang Chen, Juan Chen, Ping Chen, Yongshun Chen, Yunfeng Shan, Shuangsuo Dang, Wei-Xing Guo, Jiefeng He, Heping Hu, Bin Huang, Weidong Jia, Kexiang Jiang, Yan Jin, Yongdong Jin, Yun Jin, Gong Li, Yun Liang, Enyu Liu, Hao Liu, Wei Peng, Zhenwei Peng, Zhiyi Peng, Yeben Qian, Wanhua Ren, Jie Shi, Yusheng Song, Min Tao, Jun Tie, Xueying Wan, Bin Wang, Jin Wang, Kai Wang, Kang Wang, Xin Wang, Wenjing Wei, Fei-Xiang Wu, Bangde Xiang, Lin Xie, Jianming Xu, Mao-Lin Yan, Yufu Ye, Jinbo Yue, Xiaoxun Zhang, Yu Zhang, Aibin Zhang, Haitao Zhao, Weifeng Zhao, Xin Zheng, Hongkun Zhou, Huabang Zhou, Jun Zhou, Xinmin Zhou, Shu-Qun Cheng, Qiu Li","doi":"10.1159/000541622","DOIUrl":"10.1159/000541622","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Most HCC patients have the complications of chronic liver disease and need overall consideration and whole-course management, including diagnosis, treatment, and follow-up. To develop a reasonable, long-term, and complete management plan, multiple factors need to be considered, including the patient's general condition, basic liver diseases, tumor stage, tumor biological characteristics, treatment requirements, and economic cost.</p><p><strong>Summary: </strong>To better guide the whole-course management of HCC patients, the Chinese Association of Liver Cancer and the Chinese Medical Doctor Association has gathered multidisciplinary experts and scholars in relevant fields to formulate the \"Chinese Expert Consensus on The Whole-Course Management of Hepatocellular Carcinoma (2023).\"</p><p><strong>Key messages: </strong>This expert consensus, based on the current clinical evidence and experience, proposes surgical and nonsurgical HCC management pathways and involves 18 recommendations, including perioperative treatment, systematic treatment combined with local treatment, conversion treatment, special population management, symptomatic support treatment, and follow-up management.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"311-333"},"PeriodicalIF":11.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Expert Consensus on the Combination of Targeted Therapy and Immunotherapy with Locoregional Therapy for Intermediate/Advanced Hepatocellular Carcinoma.","authors":"Xinyu Bi, Yinying Lu, Bo Chen, Zhengqiang Yang, Zhixian Hong, Hanping Wang, Yongkun Sun, Xiaodong Wang, Chunwang Yuan, Daobing Zeng, Zhen Huang, Aiping Zhou, Wen Zhang, Shunda Du, Jianjun Zhao, Jianguo Zhou, Yirui Zhai, Xu Che, Hong Zhao, Haitao Zhao, Jianqiang Cai","doi":"10.1159/000540857","DOIUrl":"10.1159/000540857","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality; it ranks as the second most common cause of cancer deaths in China. Most HCC patients are first diagnosed at an advanced stage. In recent years, targeted therapy combined with immunotherapy has become the preferred regimen for systemic treatment of intermediate-advanced HCC, while targeted therapy combined with immunotherapy plus local treatment could further improve the efficacy in many clinical studies. To better guide the clinical treatment for effective and safe combination therapy, our interdisciplinary panel on the treatment of intermediate-advanced HCC comprising hepatologists, hepatobiliary surgeons, oncologists, radiologists, interventional radiologists, and traditional Chinese medicine physicians have formulated this consensus based on current clinical studies and clinical medication experience for reference. The consensus contained 15 recommendations, including the applicable population and management, local treatment selection, conversion strategy, treatment strategy after tumor progression and management of common adverse reactions.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"334-350"},"PeriodicalIF":11.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to \"Preoperative Prediction of Microvascular Invasion by EOB-MRI Imaging for Surgical Decision\".","authors":"Hung-Ning Tung, Chih-Horng Wu, Tung-Hung Su","doi":"10.1159/000541884","DOIUrl":"10.1159/000541884","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"351-352"},"PeriodicalIF":11.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Risk of Proteinuria with Atezolizumab plus Bevacizumab than Lenvatinib in First-Line Systemic Treatment for Hepatocellular Carcinoma.","authors":"Jiwon Yang, Won-Mook Choi, Hyung-Don Kim, Jonggi Choi, Changhoon Yoo, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee","doi":"10.1159/000541621","DOIUrl":"https://doi.org/10.1159/000541621","url":null,"abstract":"<p><strong>Introduction: </strong>Proteinuria presents a challenging complication during systemic therapy for hepatocellular carcinoma (HCC). This study aims to identify risk factors for proteinuria in patients with HCC treated with atezolizumab plus bevacizumab (Atezo/Bev) or lenvatinib (LEN) as first-line systemic treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 622 consecutive patients with unresectable HCC who received Atezo/Bev or LEN as first-line systemic treatment between October 2013 and October 2022. Cumulative incidence of proteinuria was estimated using Kaplan-Meier curves and compared using log-rank tests. Risk factors for proteinuria were identified using Cox proportional-hazard models, along with propensity score-matched and subgroup analyses.</p><p><strong>Results: </strong>Among 367 patients treated with Atezo/Bev and 255 with LEN, the cumulative incidence of proteinuria at 12 months was 27.5%. In the multivariable analysis, Atezo/Bev treatment (adjusted HR [aHR]: 1.57; 95% CI: 1.03-2.42), diabetes (aHR: 1.64; 95% CI: 1.03-2.61), hypertension (aHR: 2.27; 95% CI: 1.04-4.97), Child-Pugh class B (aHR: 3.43; 95% CI: 1.34-8.78), macrovascular invasion (MVI; aHR: 1.58; 95% CI: 1.04-2.38), and an estimated glomerular filtration rate ≤60 mL/min/1.73 m² (aHR: 3.21; 95% CI: 1.84-5.62) were identified as risk factors for proteinuria. A higher risk of proteinuria in Atezo/Bev patients compared with LEN was consistently observed in the PS-matched cohort, particularly pronounced in subgroups with MVI (HR: 2.84; 95% CI: 1.23-6.54) compared with those without MVI (HR: 1.31; 95% CI: 0.69-2.47).</p><p><strong>Conclusions: </strong>Patients treated with Atezo/Bev as first-line systemic treatment for HCC exhibited a higher risk of proteinuria compared with those with LEN, particularly when accompanied by MVI.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"180-192"},"PeriodicalIF":11.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probability of Lymph Node Metastases in Patients Undergoing Adequate Lymphadenectomy during Surgery for Intrahepatic Cholangiocarcinoma: A Retrospective Multicenter Study.","authors":"Carlo Sposito, Alessandro Cucchetti, Francesca Ratti, Laura Alaimo, Francesco Ardito, Stefano Di Sandro, Matteo Serenari, Giammauro Berardi, Marianna Maspero, Giuseppe Maria Ettorre, Matteo Cescon, Fabrizio Di Benedetto, Felice Giuliante, Andrea Ruzzenente, Giorgio Ercolani, Luca Aldrighetti, Vincenzo Mazzaferro","doi":"10.1159/000541646","DOIUrl":"10.1159/000541646","url":null,"abstract":"<p><strong>Introduction: </strong>Nodal metastases (lymph node metastasis [LNM]) are one of the major determinants of prognosis following surgery for intrahepatic cholangiocarcinoma (ICC). Previous studies investigating the correlation between clinical-radiological features and the probability of LNM include patients undergoing inadequate nodal sampling. Aim of this study was to develop a model to predict the risk of LNM in patients undergoing adequate lymphadenectomy using preoperative clinical and radiological features.</p><p><strong>Methods: </strong>Patients undergoing radical surgery for ICC with adequate lymphadenectomy at seven Italian Centers between 2000 and 2023 were collected and divided into a derivation and a validation cohort. Logistic regression and dominance analysis were applied in the derivation cohort to identify variables associated with LNM at pathology. The final coefficients were derived from the model having the highest c-statistic in the derivation cohort with the lowest number of variables included (parsimony). The model was then tested in the external validation cohort, and the linear predictor was divided into quartiles to generate four risk categories.</p><p><strong>Results: </strong>A total of 693 patients were identified. Preoperative CA 19-9, clinically suspicious lymph nodes at radiology, patients' age, and tumor burden score were significantly associated with LNM. These factors were included in a model (https://aicep.website/calculators/) showing a c-statistic of 0.723 (95% CI: 0.680, 0.766) and 0.771 (95% CI: 0.699, 0.842) in the derivation and validation cohort, respectively. A progressive increase of pathological lymph node positivity across risk groups was observed (29.9% in low-risk, 45.1% in intermediate-low risk, 51.5% in intermediate-high risk, and 87.3% in high-risk patients; <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>A novel model that combines preoperative CA 19-9, clinically suspicious lymph nodes at radiology, patients' age, and tumor burden score was developed to predict the risk of LNM before surgery. The model exhibited high accuracy and has the potential to assist clinicians in the management of patients who are candidate to surgery.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"260-270"},"PeriodicalIF":11.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating ALBI Grade with Geriatric Nutritional Risk Index Enhances Hepatocellular Carcinoma Risk Stratification.","authors":"Heechul Nam, Pil Soo Sung, Sung Won Lee, Do Seon Song, Jung Hyun Kwon, Jeong Won Jang, Chang Wook Kim, Si Hyun Bae","doi":"10.1159/000541647","DOIUrl":"https://doi.org/10.1159/000541647","url":null,"abstract":"<p><strong>Introduction: </strong>Despite its prognostic impact, nutritional status has not yet been integrated into the assessment of hepatocellular carcinoma (HCC). This study investigated the association between geriatric nutritional risk index (GNRI) and overall survival (OS) in patients with HCC using a nationwide registry.</p><p><strong>Methods: </strong>Data from the Korea Central Cancer Registry between 2008 and 2019 were analyzed. We explored the integration of the GNRI with the albumin-bilirubin (ALBI) grade for prognostic stratification. Restricted cubic spline regression was used to assess the association between GNRI and survival, stratified by ALBI grade.</p><p><strong>Results: </strong>Among the 16,416 treatment-naïve HCC patients, the ALBI grades were distributed as follows: grade 1, 7,409; grade 2, 7,445; and grade 3, 1,562. Patients were categorized according to Barcelona Clinic Liver Cancer (BCLC) stages: 5,132 stage 0/A, 2,608 stage B, 5,289 stage C, and 968 stage D. The median OS for all patients was 3.1 years (95% CI: 3.0-3.2) and significantly differed with the inclusion of ALBI grade and GNRI (<i>p</i> < 0.001). The effect of combining ALBI grade and GNRI was further evaluated for each BCLC stage. This risk stratification showed a significant correlation with OS for each BCLC stage (all <i>p</i> < 0.001), except for stage D (<i>p</i> = 0.082). Multivariate analysis revealed that a combination of favorable ALBI grade and high GNRI score was independently associated with decreased mortality risk.</p><p><strong>Conclusion: </strong>The GNRI was significantly correlated with OS across ALBI grades and BCLC stages. Integrating the GNRI into the ALBI grade may enhance risk stratification for patients with HCC.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"193-210"},"PeriodicalIF":11.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcome of a Multicenter Prospective Study on Efficacy and Safety of High-Dose Stereotactic Body Radiation Therapy ≥48-h Interfraction Interval for ≤5 cm Hepatocellular Carcinoma.","authors":"Jin-Kyu Kang, Mi-Sook Kim, Won Il Jang, Chul Ju Han, Jin Kim, Su Cheol Park, Young-Joo Shin, Chul Won Choi, Wan Jeon, Tosol Yu, Ah Ram Chang, Hae Jin Park, Younghee Park, Eun Seog Kim, Sunmi Jo, Woo Chul Kim, Hun Jung Kim, Sun Hyun Bae, Eunji Kim","doi":"10.1159/000541685","DOIUrl":"10.1159/000541685","url":null,"abstract":"<p><strong>Introduction: </strong>The goal of this study was to evaluate the efficacy and safety of high-dose stereotactic body radiation therapy (SBRT) with an extended (48 h or more) interfraction interval for hepatocellular carcinoma (HCC) ≤5 cm in size after incomplete response to transarterial chemoembolization (TACE).</p><p><strong>Methods: </strong>This multicenter prospective study included 54 patients with inoperable HCC of ≤5 cm size between July 2012 and June 2015. A total SBRT dose of 60 Gy in 3 fractions was administered within 14 days with ≥48-h interfraction interval to patients who showed an incomplete response after 1-5 sessions of TACE. Treatment responses were defined according to the modified Response Evaluation Criteria for Solid Tumors. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 4.0.</p><p><strong>Results: </strong>Forty-eight patients were evaluated with a median follow-up period of 66 months (range, 2-126 months). The median tumor size was 2.0 cm (range, 1.0-4.5 cm), and most patients (87.5%) had a single lesion. The 1-, 2-, and 5-year local control (LC) rates were 100%, 94.8%, and 90.7%, respectively. The 1-, 2-, and 5-year progression-free survival (PFS) rates were 63.4%, 56.9%, and 24.9%, respectively. The 1-, 2-, and 5-year overall survival (OS) rates were 95.6%, 90.9%, and 76.5%, respectively. None of the patients experienced grade 3+ gastrointestinal toxicity, while 1 patient developed non-classic radiation-induced liver disease 2 months after SBRT.</p><p><strong>Conclusion: </strong>High-dose SBRT with a ≥48-h interfraction interval after incomplete response to TACE is effective for HCC ≤5 cm in size as evidenced by the high rates of LC and OS and acceptable treatment-related toxicity.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 3","pages":"248-259"},"PeriodicalIF":11.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Radiation Dose and Tumour Burden on Outcomes in Hepatocellular Carcinoma: 11-Year Experience in a 413-Patient Cohort Treated with Yttrium-90 Resin Microsphere Radioembolisation.","authors":"Kaina Chen, Aaron K T Tong, Fiona N N Moe, David C E Ng, Richard H G Lo, Apoorva Gogna, Sean X Yan, Sue Ping Thang, Kelvin S H Loke, Nanda Karaddi Venkatanarasimha, Hian Liang Huang, Chow Wei Too, Timothy S K Ong, Eng Xuan Yeo, Daniel Yang Yao Peh, Ashley W Y Ng, Lu Yang, Wan Ying Chan, Jason P E Chang, Brian K P Goh, Han Chong Toh, Pierce K H Chow","doi":"10.1159/000541539","DOIUrl":"https://doi.org/10.1159/000541539","url":null,"abstract":"<p><strong>Introduction: </strong>Transarterial radioembolisation (RE) using yttrium-90 (Y-90) microspheres is a widely used locoregional therapy for a broad spectrum of hepatocellular carcinoma (HCC) given its favourable safety profile. We evaluated the real-world outcomes of unresectable HCC treated with resin Y-90 RE and the relationship between tumour absorbed dose and subsequent curative therapy with survival.</p><p><strong>Methods: </strong>Included were consecutive patients treated with Y-90 resin microspheres RE for unresectable HCC between January 2008 and May 2019 at the National Cancer Centre Singapore/Singapore General Hospital. The outcomes were stratified by tumour burden, distribution, presence of portal vein invasion (PVI) and liver function to improve prognostication.</p><p><strong>Results: </strong>The median overall survival (OS) evaluated on 413 included patients was 20.9 months (95% CI: 18.2-24.0). More than half of the patients (214/413, 51.8%) had HCC beyond up-to-seven criteria, and 37.3% had portal vein invasion (154/413, 37.3%). Majority (71.7%) had dosimetry calculated based on the partition model. Patients who received ≥150 Gy to tumour had significantly better outcomes (OS 32.2 months, 95% CI: 18.3-46.4) than those who did not (OS 17.5 months, 95% CI: 13.7-22.7, <i>p</i> < 0.001). Seventy patients (17%) received curative therapies after tumour was downstaged by Y-90 RE and had better OS of 79.7 months (95% CI: 40.4 - NE) compared to those who did not receive curative therapies (OS 17.1 months; 95% CI: 13.5-20.4, <i>p</i> < 0.001). RE-induced liver injury was observed in 5.08% of the patients while 3.2% of the patients had possible radiation pneumonitis but none developed Grade 3-4 toxicity. For HCC without PVI, OS differed significantly with performance status, albumin-bilirubin grade, tumour distribution, and radiation dose; for HCC with PVI, Child-Pugh class and AFP were significant predictors of survival.</p><p><strong>Conclusions: </strong>Treatment outcomes for unresectable HCC using Y-90 RE were favourable. Incorporating tumour burden and distribution improved prognostication. Patients who received tumour absorbed dose above 150 Gy had better OS. Patients who subsequently received curative therapies after being downstaged by Y-90 RE had remarkable clinical outcomes.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"158-179"},"PeriodicalIF":11.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depth of Radiographic Response as an Independent Prognostic Factor for Patients with Initially Unresectable Hepatocellular Carcinoma Receiving Hepatectomy following Targeted Therapy plus Immunotherapy.","authors":"Bin Xu, Lu-Na Wang, Zi-Yi Wang, Tian He, Xiao-Dong Zhu, Ying-Hao Shen, Jian Zhou, Jia Fan, Hui-Chuan Sun, Cheng Huang","doi":"10.1159/000541300","DOIUrl":"https://doi.org/10.1159/000541300","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical resection following systemic therapy is feasible in patients with initially unresectable hepatocellular carcinoma (HCC). However, postoperative tumor recurrence is common after surgery, and the factors affecting this recurrence remain unclear. This study aimed to assess factors influencing postoperative outcomes in patients with initially unresectable HCC undergoing hepatectomy after systemic therapy.</p><p><strong>Methods: </strong>This study retrospectively enrolled patients with initially unresectable HCC who underwent hepatectomy after targeted therapy plus immunotherapy (with or without locoregional therapy). Multivariate Cox regression analyses were used to identify the independent prognostic factors for recurrence-free survival (RFS) and overall survival (OS). Machine learning was used to determine the RFS rates at different intervals for different radiographic responses.</p><p><strong>Results: </strong>Eighty-one patients who underwent R0 hepatectomy after systemic therapy were included. With a median follow-up of 17.4 (interquartile range: 7.2-22.3) months, median RFS and OS were not reached. Preoperative tumor downstaging and achieving pathological complete response were associated with improved RFS and OS. Multivariate Cox analyses identified radiographic response as an independent prognostic factor for RFS and OS. Furthermore, a radiographic response >40% (assessed using the Response Evaluation Criteria in Solid Tumors, version 1.1) or >50% (assessed using the modified Response Evaluation Criteria in Solid Tumors) was associated with a longer RFS (<i>p</i> = 0.006 and 0.003, respectively).</p><p><strong>Conclusion: </strong>Radiographic response depth was an independent prognostic factor in patients with initially unresectable HCC who underwent hepatectomy following targeted therapy plus immunotherapy, and the response to systemic therapy may be the determining factor for patient prognosis after surgery.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"142-157"},"PeriodicalIF":11.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus of Chinese Experts on Neoadjuvant and Conversion Therapies for Hepatocellular Carcinoma: 2023 Update.","authors":"Xinyu Bi, Haitao Zhao, Hong Zhao, Guangming Li, Xiaodong Wang, Bo Chen, Wen Zhang, Xu Che, Zhen Huang, Yue Han, Liming Jiang, Yongkun Sun, Zhengqiang Yang, Jianguo Zhou, Yefan Zhang, Zhenyu Zhu, Minshan Chen, Shuqun Cheng, Jianqiang Cai","doi":"10.1159/000541249","DOIUrl":"https://doi.org/10.1159/000541249","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a common malignancy in China, with high recurrence rate and low resection rate among patients first diagnosed. Preoperative treatments including neoadjuvant and conversion therapy have the potential to overcome these challenges. In December 2021, <i>Chinese expert consensus on neoadjuvant and conversion therapies for hepatocellular carcinoma</i> was published. With the emersion of new evidence regarding the neoadjuvant and conversion therapies for HCC, the cooperative group brought together multidisciplinary researchers and scholars with experience in related fields to update the new edition (2023 Edition) for reference in China, including principle of the treatment strategies, the potential populations selection, treatment methods, multidisciplinary team, and future research for preoperative treatments. The new consensus aims to provide guidance for clinical application. Through the use of neoadjuvant therapy and conversion therapy, we can enhance the resection rate and reduce the recurrence of intermediate-to-advanced HCC patients, thereby improving survival outcomes.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 2","pages":"223-238"},"PeriodicalIF":11.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}