Liver Cancer最新文献

{"title":"Clinical Prediction of Glycolysis-Driven Molecular Subclass of Hepatocellular Carcinoma without Transcriptomic Profiling.","authors":"Tomoko Aoki, Masatoshi Kudo, Satoshi Ogiso, Genki Okumura, Megumi Hoshino, Yuka Nakamura, Ryo Morisue, Shohei Koyama, Naoshi Nishida, Kohei Hanaoka, Kazuko Sakai, Yutaka Kurebayashi, Masakatsu Tsurusaki, Masahiro Morita, Atsushi Takebe, Takaaki Murase, Keiko Kamei, Ippei Matsumoto, Kazuto Nishio, Hiroyoshi Nishikawa, Etsuro Hatano","doi":"10.1159/000551362","DOIUrl":"10.1159/000551362","url":null,"abstract":"<p><strong>Introduction: </strong>Glycolysis-driven hepatocellular carcinoma (HCC) has been associated with resistance to immune checkpoint inhibitors; however, clinical implementation of glycolysis-targeted therapies remains limited by the reliance on transcriptomic subclassification.</p><p><strong>Methods: </strong>We developed a logistic regression model using clinical and pathological features to predict transcriptome-defined glycolysis subclass (training cohort, <i>n</i> = 113). An integer-based scoring system was derived for bedside application. Model performance was assessed using classification metrics, with external validation in TCGA-LIHC cohort. Imaging correlations were analyzed with <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in a clinical cohort (<i>n</i> = 133) lacking transcriptomic data. In addition, pathology-free LASSO model was also developed using <sup>18</sup>F-FDG PET/CT, contrast-enhanced CT/Gd-MRI, and serum biomarkers.</p><p><strong>Results: </strong>The integer logistic model (cutoff ≥3), incorporating serum α-fetoprotein, serum albumin, arterial enhancement pattern, and histopathological phenotypes (macrotrabecular-massive, compact, and pseudoglandular), achieved an area under the receiver operating characteristic curve (AUROC) of 0.905, accuracy of 0.850, and F1 score of 0.80 in the training cohort, with consistent performance across subgroups. External validation using the fully annotated subset of the TCGA-LIHC cohort (<i>n</i> = 70) demonstrated preserved model performance (AUROC = 0.825). When applied to the clinical cohort, predicted glycolysis-enhanced HCCs demonstrated significantly higher <sup>18</sup>F-FDG uptake and distinct hepatobiliary phase defect on Gd-EOB-DTPA-enhanced MRI. Patients classified as the glycolysis subclass showed a trend toward shorter overall survival (median 95 months, <i>p</i> = 0.079) and significantly shorter recurrence-free survival (median 14.4 vs. 37.7 months, <i>p</i> = 0.017). Visual <sup>18</sup>F-FDG PET positivity was strongly associated with the glycolysis subclass (<i>p</i> < 0.001) and corresponded to a tumor-to-liver uptake ratio ≥1.51. A pathology-free LASSO model using four non-invasive variables demonstrated robust predictive performance (AUROC = 0.893). Elevated glycolytic activity was exploratively correlated with lower CD8<sup>+</sup> T-cell infiltration and increased PD-1<sup>+</sup>CTLA-4<sup>+</sup>CD8<sup>+</sup> T cells.</p><p><strong>Conclusion: </strong>We provide a transcriptomics-independent logistic regression model for identifying glycolysis-enhanced HCC. This approach enables practical metabolic subclassification of HCC using routinely available clinical data. Macrotrabecular-massive and compact histopathological patterns, inhomogeneous arterial hyperenhancement, elevated serum α-fetoprotein levels, and <sup>18</sup>F-FDG PET positivity are character","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839757","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":"Low Tumor Burden Predicts Benefit from Transarterial Treatment in Hepatocellular Carcinoma with Extrahepatic Metastasis: A Nationwide Cohort Study.","authors":"Jaejun Lee, Hyun Yang, Keungmo Yang, Ji Won Han, Pil Soo Sung, Jeong Won Jang, Si Hyun Bae","doi":"10.1159/000551158","DOIUrl":"10.1159/000551158","url":null,"abstract":"<p><strong>Background/aims: </strong>In patients with hepatocellular carcinoma (HCC) and extrahepatic metastasis (EHM), intrahepatic disease control may remain clinically relevant in selected cases. This study aimed to compare survival outcomes between transarterial treatment (TAT) and systemic therapy (ST) as initial treatment.</p><p><strong>Methods: </strong>Data from the Korean Central Cancer Registry (2008-2020) were analyzed. TAT included chemoembolization, radioembolization, and hepatic arterial infusion chemotherapy. Systemic therapy consisted predominantly of tyrosine kinase inhibitors (>98%). Overall survival (OS) was the primary endpoint. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) adjusted for confounding.</p><p><strong>Results: </strong>Among 19,753 treatment-naïve HCC patients, 2,517 had EHM. Of these, 663 received TAT and 595 received ST as initial therapy. In the overall cohort, TAT was associated with significantly longer OS than ST (median OS: 6.7 vs. 3.7 months, <i>p</i> < 0.001), and this benefit remained in both PSM and IPTW analyses (<i>p</i> < 0.001 for both). The advantage of TAT persisted across subgroups defined by metastatic site, number of metastatic organs, portal vein tumor thrombosis (PVTT), and tumor size, although the difference narrowed in tumors >10 cm. Multivariable analysis identified TAT, single-organ metastasis, alpha-fetoprotein <400 ng/mL, and absence of PVTT as independent predictors of improved survival. TAT showed better survival in patients with low tumor burden, defined as intrahepatic tumor size <10 cm or metastasis confined to lymph nodes. In contrast, no significant difference was seen in those with high tumor burden, including large tumors and EHM beyond lymph nodes.</p><p><strong>Conclusion: </strong>These findings suggest that TAT may be a viable initial treatment option for selected HCC patients with EHM, particularly those with lower tumor burden. Further comparative studies, especially with immunotherapy, are needed to define its optimal role in clinical practice.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839793","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":"Integrated Multi-Omics Profiling Identifies an Immunotherapy Vulnerable and Prognostic Associated Subtype in Cholangiocarcinoma.","authors":"Lu Chen, Yuchao He, Hong Su, Xiangdong Tian, Haotian Liao, Dongming Liu, Meng Zhao, Huichuan Sun, Lisha Qi, Manqing Cao, Zhiyong Liu, Lin Guo, Guangtao Li, Chenhao Zhou, Yi Luo, Liwei Chen, Qiang Wu, Yunlong Cui, Huikai Li, Xiaolin Zhu, Feng Fang, Wei Zhang, Shaojun Zhang, Tianqiang Song, Hua Guo","doi":"10.1159/000550945","DOIUrl":"10.1159/000550945","url":null,"abstract":"<p><strong>Introduction: </strong>Cholangiocarcinoma (CCA) is an aggressive malignancy with poor prognosis and limited treatment options. Molecular heterogeneity and the tumor immune microenvironment play crucial roles in CCA progression and therapeutic response, but comprehensive stratification remains insufficient for guiding treatment decisions.</p><p><strong>Methods: </strong>This study performed integrated multi-omics profiling as well as immunohistochemical validation on 424 CCA patients. Multidimensional data, including genomic, epigenomic, transcriptomic, and immune profiling, were analyzed to identify clinically relevant molecular subtypes.</p><p><strong>Results: </strong>Four distinct molecular subtypes of CCA were identified, each exhibiting unique clinical and immunological features: C1 (proliferation): driven by <i>TP53/KRAS</i> mutations and CpG island methylator phenotype (CIMP+) hypermethylation, showing T helper 17 cells infiltration and poor outcomes; C2 (Immune-Suppressed Macro_LYVE1 [ISM_LYVE1]): stroma-rich with LYVE1⁺ macrophages and epithelial-mesenchymal transition (EMT) activation; C3 (immune-activated Macro_C1QC (IAM_C1QC)): enriched in C1QC⁺ macrophages, CD8⁺ T-cells, and metabolic pathways, highly responsive to immune checkpoint blockade (ICB; 75% overall response rate); C4 (immune exclusion): <i>FGFR2</i>-altered and <i>IDH1</i>-mutant, with an immunologically cold phenotype.</p><p><strong>Conclusion: </strong>We validated ATP2B1 as a novel prognostic biomarker and developed a 160-gene classifier for subtype prediction. The C3 subtype's exceptional ICB response, independent of conventional biomarkers (PD-L1/microsatellite instability/tumor mutational burden), highlights the clinical utility of this classification system in guiding precision immunotherapy for CCA.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774775","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":"Erratum.","authors":"","doi":"10.1159/000550390","DOIUrl":"https://doi.org/10.1159/000550390","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000547996.].</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307230","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":"Impact of Age on Patient-Reported Outcomes with First-Line Camrelizumab plus Rivoceranib versus Sorafenib in Adults with Unresectable Hepatocellular Carcinoma: Post Hoc Analyses of the CARES-310 Open-Label, Randomized, Phase 3 Trial.","authors":"Stephen Lam Chan, Ahmed Omar Kaseb, Laura Alexander, Xianzhang Meng, Kristin Ryan, Wei Shi, Arndt Vogel","doi":"10.1159/000551156","DOIUrl":"10.1159/000551156","url":null,"abstract":"<p><strong>Introduction: </strong>The CARES-310 randomized, open-label, international phase 3 trial reported improved overall survival and progression-free survival with camrelizumab-rivoceranib compared with sorafenib in adults with unresectable hepatocellular carcinoma (uHCC).</p><p><strong>Methods: </strong>We performed a post hoc analysis of data from CARES-310 to evaluate patient-reported outcomes (PROs), survival, and safety in adults <65 years and ≥65 years. PRO endpoints included time to deterioration with a ≥10-point decrease from baseline of health-related quality of life (HRQoL), physical functioning, role functioning, and symptoms.</p><p><strong>Results: </strong>PRO data for these age cohorts demonstrated clinically meaningful benefits with camrelizumab-rivoceranib versus sorafenib in key aspects of the patient experience such as HRQoL, functioning, pain, and fatigue. Similarly, both age groups had a significant survival outcome advantage on camrelizumab-rivoceranib versus sorafenib. Although patients treated with camrelizumab-rivoceranib had higher rates of treatment-related adverse events versus sorafenib, this did not adversely affect HRQoL as assessed by PROs. The most common ≥20% grade ≥3 treatment-related adverse events in the camrelizumab-rivoceranib arm were hypertension and increased AST versus palmar-plantar erythrodysesthesia syndrome in the sorafenib arm.</p><p><strong>Conclusion: </strong>These results support the favorable benefit-risk profile of camrelizumab-rivoceranib in patients <65 years and ≥65 years as a first-line therapy in patients with uHCC who have not received prior systemic therapy.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674768","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":"Survival Outcomes, Recurrence Patterns, and Its Corresponding Therapeutic Management after Conversion Therapy Followed by Curative Resection for Hepatocellular Carcinoma: A Real-World Study.","authors":"Rui Xiao, Zhenyun Yang, Zehao Zheng, Na Liu, Wei Yu, Qingyang Lin, Jinbin Chen, Juncheng Wang, Zhongguo Zhou, Yaojun Zhang, Minshan Chen, Dandan Hu","doi":"10.1159/000550954","DOIUrl":"10.1159/000550954","url":null,"abstract":"<p><strong>Introduction: </strong>There remains a scarcity of research focusing on long-term survival, the administration of adjuvant therapy, and recurrence following conversion resection in patients suffering from initially unresectable hepatocellular carcinoma (uHCC). Our study aimed to provide a comprehensive understanding of clinical outcomes and recurrence after conversion resection of initially uHCC patients.</p><p><strong>Methods: </strong>We retrospectively collected historically confirmed HCC patients who had undergone curative resection after conversion therapy between November 2014 to June 2023. The primary endpoints included overall survival (OS) and overall survival after recurrence (rOS). The second endpoints included recurrence-free survival (RFS). BCLC staging system was applied to classify recurrence patterns (rBCLC).</p><p><strong>Results: </strong>A total of 419 initially uHCC patients were collected in Sun Yat-sen University Cancer Center. The median duration of follow-up was 44.3 months (95% CI, 26.4-62.3). These patients exhibited a median OS not reached and a median RFS of 16.8 months (95% CI, 11.5-22.1) after conversion resection. The achieving of CR according to mRECIST and pathological response ≥90% predicted better OS and RFS, while a decline of AFP or PIVKA-II ≥75% after conversion therapy predicted better RFS. Postoperative adjuvant therapy did not exhibit significantly improved OS or RFS compared to active surveillance before and after propensity score matching or inverse probability of treatment weighting. Subgroup analyses failed to identify any population with clear benefit from adjuvant therapy, either. Recurrence occurred in 261 (62.3%) patients at a median time of 7.2 months after resection. Median rOS for recurrent patients was 40.2 months (95% CI, 33.4-48.7). Patients with rBCLC stage 0/A exhibited significantly better rOS compared to those with rBCLC stage B/C. Across all rBCLC stages, curative treatment was identified as the optimal therapeutic strategy for achieving the best rOS. Furthermore, combination therapy did not demonstrate superior efficacy over transarterial therapy or systemic therapy alone at any recurrent disease stage.</p><p><strong>Conclusion: </strong>Patients with uHCC exhibited favorable prognosis after conversion resection. Tumor response of conversion therapy could predict clinical outcomes after conversion resection. Our data did not support the routine use of postoperative adjuvant therapy. When recurrence occurred, more intense and aggressive treatments were not supported by current evidence.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698447","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":"Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging for Predicting Immunotherapy Response in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Wenbo Xie, Linmao Sun, Yumin Fu, Shuhang Liang, Yao Liu, Jiabei Wang, Lianxin Liu","doi":"10.1159/000550938","DOIUrl":"10.1159/000550938","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) harboring CTNNB1 mutations that activate the Wnt/β-catenin pathway demonstrates increased gadoxetic acid (Gd-EOB-DTPA) uptake due to overexpressed organic anion transporting polypeptide 1B3 (OATP1B3) and exhibits immune checkpoint inhibitor (ICI) resistance attributed to an immune-excluded tumor microenvironment and tumor immune barriers. This systematic review investigated Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) for predicting immunotherapy response in HCC.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, and Cochrane was conducted up to September 10, 2025. Studies linking relative enhancement ratio (RER) >0.9 on Gd-EOB-DTPA-enhanced MRI to progression-free survival (RECIST 1.1) in immunotherapy-treated patients were included. Following PRISMA 2020/SWiM guidelines, risk of bias was assessed via QUADAS-2. Meta-analysis was performed using JASP (v0.95.4) via a random-effects model with restricted maximum likelihood estimation. Heterogeneity was assessed using <i>I</i> ² and <i>τ</i> ². Notably, the Knapp-Hartung adjustment was applied to calculate 95% confidence interval (CI) to ensure robust inference despite the limited study number. Sources of heterogeneity and robustness were explored using subgroup analyses, meta-regression, and sensitivity analyses.</p><p><strong>Results: </strong>Five studies (<i>n</i> = 253; published 2021-2025) were analyzed. RER ≥0.9 was identified as a significant predictor of poor response across diverse ICI regimens, with a pooled hazard ratios (HR) of 5.79 (95% CI: 1.56-21.50; <i>p</i> = 0.020) and individual estimates ranging from 1.58 to 22.04. However, further analysis indicated that anti-VEGF therapy might mitigate this resistance and partially restore ICI efficacy; the association between high RER and poor survival was not statistically significant in the anti-VEGF cohort (HR = 3.39; 95% CI: 0.39-29.14; <i>p</i> = 0.135).</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first systematic review evaluating the predictive utility of Gd-EOB-DTPA-enhanced MRI for HCC immunotherapy. Our findings suggest that an RER ≥0.9 serves as a potential noninvasive marker for poor treatment response. Notably, the observation that anti-VEGF combination therapy might mitigate this imaging-defined resistance is hypothesis-generating, underscoring the need for prospective studies to validate optimal strategies for patients with high-RER tumors.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774796","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":"Comparative Efficacy of Initial Treatment Strategies in Patients with Transarterial Chemoembolisation-Unsuitable Hepatocellular Carcinoma.","authors":"Edoardo G Giannini, Andrea Pasta, Giulia Pieri, Sara Labanca, Simona Marenco, Mario Strazzabosco, Mohamed Bouattour, Clémence Hollande, Antonio Facciorusso, Paolo Gallo, Ciro Celsa, Angelo Sangiovanni, Bernardo Stefanini, Claudia Campani, Gabriele Missale, Gianpaolo Vidili, Giorgia Ghittoni, Elisa Pinto, Francesco Giuseppe Foschi, Filomena Morisco, Giacomo Zaccherini, Gianluca Svegliati-Baroni, Francesco Azzaroli, Carlo Saitta, Maurizia Rossana Brunetto, Rodolfo Sacco, Francesca Romana Ponziani, Sara Boninsegna, Gerardo Nardone, Andrea Martini, Andrea Mega, David Sacerdoti, Donatella Magalotti, Maria Di Marco, Alessandro Vitale, Laura Bucci, Franco Trevisani","doi":"10.1159/000551050","DOIUrl":"10.1159/000551050","url":null,"abstract":"<p><strong>Introduction: </strong>Transarterial chemoembolisation (TACE) is considered the standard-of-care for patients with intermediate-stage hepatocellular carcinoma (HCC), despite several patients exhibit features that may be associated with suboptimal outcome of treatment - also referred to as TACE-unsuitable. In this study, our aim was to provide real-world evidence that patients who are considered TACE-unsuitable may receive greater benefit by systemic therapy than by TACE.</p><p><strong>Methods: </strong>This study analysed 1,150 patients with TACE-unsuitable HCC, defined according to Asia-Pacific Primary Liver Cancer Expert criteria. Patients were initially treated with TACE (<i>n</i> = 842), sorafenib (<i>n</i> = 96), lenvatinib (<i>n</i> = 62), or atezolizumab/bevacizumab (<i>n</i> = 47). Overall survival (OS) was the primary endpoint. Inverse probability of treatment weighting was applied to adjust for baseline differences.</p><p><strong>Results: </strong>Compared to TACE, atezolizumab/bevacizumab reduced mortality risk (hazard ratio [HR]: 0.47, 95% confidence interval [95% CI]: 0.27-0.80; <i>p</i> = 0.008), lenvatinib was neutral (HR: 0.62, 95% CI: 0.35-1.08; <i>p</i> = 0.091), and sorafenib was associated with increased mortality (HR: 1.85, 95% CI: 1.28-2.65; <i>p</i> = 0.001). OS at 24 months was 60.2% for TACE, 31.9% for sorafenib, 68.3% for lenvatinib, and 70.5% for atezolizumab/bevacizumab (<i>p</i> < 0.0001). The disease control rate was 53.2% with TACE, 47.9% with sorafenib, 67.8% with lenvatinib (<i>p</i> = 0.030 versus TACE; <i>p</i> = 0.025 versus sorafenib), and 75.6% with atezolizumab/bevacizumab (<i>p</i> < 0.001 versus TACE; <i>p</i> < 0.001 versus sorafenib).</p><p><strong>Conclusions: </strong>In TACE-unsuitable patients, systemic treatment with atezolizumab/bevacizumab and, to a lesser extent, lenvatinib is associated with improved outcome compared to TACE. These findings support a paradigm shift in the initial management of intermediate-stage HCC, favouring the early use of systemic therapy in appropriately selected patients.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774604","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":"Physical Activity Improves Overall Survival in Patients with Hepatocellular Carcinoma.","authors":"Byeong Geun Song, Myeongcheol Lee, Juhee Cho, Geum-Youn Gwak, Danbee Kang, Dong Hyun Sinn","doi":"10.1159/000550923","DOIUrl":"10.1159/000550923","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity improves survival in various cancers, but its impact in patients with hepatocellular carcinoma (HCC) remains unexplored. We aimed to investigate the association between initiating moderate-to-vigorous physical activity (MVPA) after HCC diagnosis and overall survival among previously inactive patients.</p><p><strong>Methods: </strong>This retrospective cohort study used Korean National Health Insurance Service data from 21,035 adults diagnosed with HCC between 2010 and 2023 who were physically inactive before diagnosis and completed biennial health examinations pre- and post-diagnosis. MVPA initiation was assessed through standardized questionnaires. Primary outcome was all-cause mortality; secondary outcomes were cancer-specific and non-cancer-specific mortality. Cox models estimated adjusted hazard ratios and 95% confidence intervals.</p><p><strong>Results: </strong>Among 21,035 patients (mean age 62.1 years; 78.1% male), 5,639 (26.8%) initiated MVPA and 15,396 (73.2%) remained inactive. During follow-up, 7,122 deaths occurred. The 12-year cumulative mortality was lower with MVPA initiation versus remaining inactive (53.9% vs. 61.2%; adjusted HR, 0.86; 95% CI, 0.82-0.92). Consistent associations were observed in patients receiving curative treatment (HR, 0.86; 95% CI, 0.78-0.95), those without curative treatment (HR, 0.87; 95% CI, 0.81-0.93), patients with viral HCC (HR, 0.87; 95% CI, 0.81-0.93), nonviral HCC (HR, 0.86; 95% CI, 0.77-0.96), cirrhotic patients (HR, 0.86; 95% CI, 0.80-0.93), and non-cirrhotic patients (HR, 0.88; 95% CI, 0.81-0.96). Propensity score-matched analysis confirmed these findings (HR, 0.87; 95% CI, 0.82-0.92).</p><p><strong>Conclusion: </strong>Among physically inactive adults with HCC, initiating MVPA after diagnosis was associated with lower mortality compared with remaining inactive, suggesting that promoting physical activity should be considered in comprehensive HCC care.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609416","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":"Impact of Procedural Quality on Outcomes of Transarterial Chemoembolization for Hepatocellular Carcinoma: A Multicenter Study.","authors":"Nan Jiang, Wen Zhang, Zhenwei Peng, Chang Liu, Yu-Dong Xiao, Wei-Zhu Yang, Rong Ding, Li-Nan Yin, Jian-Qiang Jiang, Cai-Fang Ni, Zhi-Ping Yan, Ming Kuang, Gao-Jun Teng, Bin-Yan Zhong","doi":"10.1159/000550734","DOIUrl":"10.1159/000550734","url":null,"abstract":"<p><strong>Introduction: </strong>Transarterial chemoembolization (TACE) is the primary treatment modality for intermediate-stage hepatocellular carcinoma (HCC). However, the lack of standardization to optimal technique leads to a wide variation in outcomes. This study aimed to evaluate the impact of procedure quality of TACE on HCC management.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included HCC patients with ≤4 tumors (maximum diameter ≤7 cm) treated with TACE monotherapy as first-line treatment between January 2009 and December 2022. Patients were classified into precision TACE and non-precision TACE groups based on adherence to predefined technical criteria encompassing angiography, catheterization, embolic agents, embolization endpoints, and assessment. The procedural quality was further stratified using a scoring system (where points were deducted for technical deficiencies). The primary outcome was objective response rate (ORR) after first TACE (first ORR) based on modified Response Evaluation Criteria in Solid Tumors. Secondary outcomes included overall ORR, progression-free survival (PFS), overall survival (OS), and safety profiles.</p><p><strong>Results: </strong>The analysis included 3,059 patients (median age, 58.00 years [IQR: 49.00-66.00]; 2,592 males [84.7%]) with 2,286 patients included in precision TACE and 773 patients included in non-precision TACE group. First ORR was 59.4% (1,359/2,286) in the precision TACE group versus 47.0% (363/773) in the non-precision TACE group (<i>p</i> < 0.001), with overall ORR of 70.6% (1,615/2,286) versus 59.8% (462/773) (<i>p</i> < 0.001). Median PFS was 14.00 months (IQR: 7.13-32.80) versus 10.80 months (IQR: 5.00-25.30) (HR = 0.787 [95% CI: 0.719-0.861], <i>p</i> < 0.001), and median OS was 33.63 months (IQR: 16.13-78.21) versus 26.37 months (IQR: 13.00-55.57) (HR = 0.792 [95% CI: 0.716-0.876], <i>p</i> < 0.001). The quality scoring system demonstrated a direct correlation between procedural quality and treatment response. Patients in precision TACE group had lower rates of hepatobiliary toxicity (elevated total bilirubin, 17.4% [398/2,286] vs. 33.8% [261/773], <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Precision TACE was associated with improved outcomes and safety in HCC. The proposed scoring system correlates with treatment outcomes, suggesting its utility as a quality assessment tool for TACE procedures.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":" ","pages":""},"PeriodicalIF":10.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592986","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}