{"title":"Machine learning model stratify hepatocellular carcinoma patient into high- and low-risk recurrence or death group post curative resection.","authors":"Jun-Jun Jia, Yu-Yang Wang, Xin-Yue Tan, Yu Nie, Shu-Sen Zheng, Hang-Jin Jiang","doi":"10.1016/j.hbpd.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>The high recurrence rate of hepatocellular carcinoma (HCC) following curative resection affects patient survival. The present study combined critical clinicopathological features and molecular markers to develop machine learning models to predict the risk of recurrence and mortality. We aimed to individualize risk stratification, post-surgical management strategies, and ultimately improve long-term prognosis for HCC patients with curative resections.</p><p><strong>Methods: </strong>A total of 815 HCC patients undergoing surgical resection were divided randomly into a training cohort (n = 652) and a validation cohort (n = 163). To build a high-accuracy recurrent/death classifier using clinicopathological characteristics and molecular biomarkers, four different machine learning models, including the Cox proportional risk model, generalized linear model, extreme gradient boosting (XGBoost) model, and random survival forest (RSF) model, were developed and comprehensively compared. The outcomes were recurrence-free survival (RFS) and overall survival (OS).</p><p><strong>Results: </strong>Factors including diabetes, albumin, tumor numbers, HCC diameter, portal vein tumor thrombus, blood loss, mismatch repair protein 2 (MSH2), and epithelial membrane antigen were significantly associated with RFS, while albumin, HCC diameter, MSH2, and Barcelona Clinic Liver Cancer (BCLC) stage were significantly associated with OS. The RSF model not only grouped HCC patients into high- and low-probability recurrence groups with significant differences in 5-year recurrence probability rate (training cohort: 87.3 % vs. 51.5 %, P < 0.0001; validation cohort: 75.9 % vs. 64.8 %, P < 0.0001), but also grouped HCC patients into high- and low-probability death groups with significant differences in 5-year death probability rate (training cohort: 56.0 % vs. 15.3 %, P < 0.0001; validation cohort: 50.0 % vs. 23.1 %, P < 0.0001).</p><p><strong>Conclusions: </strong>The RSF model accurately stratified HCC patient into high- and low-risk recurrence or death groups, which guides the surgeons to plan adjuvant therapy after surgery.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epidemiological trends and burden of gallbladder and biliary tract cancer in Belt and Road Initiative countries: A comprehensive analysis from the Global Burden of Disease 2021 database.","authors":"Hao Wu, Qian-Qian Feng, Jian-Hui Li, Hai-Yang Xie, Shi-Gui Yang, Shu-Sen Zheng","doi":"10.1016/j.hbpd.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>With increasing life expectancy and aging populations, Belt and Road Initiative (BRI) countries face various levels of gallbladder and biliary tract cancer (GBTC) impact. This study analyzed differences in the burden and trends of GBTC in BRI countries from 1990 to 2021, providing a comprehensive understanding of geographic, temporal, and demographic variations to inform targeted public health strategies.</p><p><strong>Methods: </strong>Using the Global Burden of Disease (GBD) 2021 database, we examined age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized disability-adjusted life year rate of GBTC across 153 BRI countries. A Bayesian Age-Period-Cohort (BAPC) model analyzed temporal trends (1990-2021) and projected future burden (2035). We assessed the relationship between sociodemographic index (SDI) and GBTC burden, conducted sex- and age-stratified analyses, and evaluated geographic disparities.</p><p><strong>Results: </strong>In 2021, global age-standardized incidence rate was 2.56/100 000 (216 768 cases), with age-standardized prevalence rate 3.69/100 000 (314 465 cases), age-standardized mortality rate 2.04/100 000 (171 961 deaths), and age-standardized disability-adjusted life year rate 43.2/100 000 (3.73 million disability-adjusted life years). Geographic analysis identified Thailand, Korea, and Chile as regions with the highest age-standardized incidence rate and age-standardized mortality rate. Age-standardized disability-adjusted life year rate correlated positively with SDI (R = 0.38) across BRI countries. Between 1990 and 2021, temporal trends showed age-standardized mortality rate and age-standardized disability-adjusted life year rate declined globally (-24.09/100 000 and -26.25/100 000), but South Asia showed increased mortality rate (+33.24/100 000 and +28.15/100 000). Globally, age-standardized mortality rate and age-standardized disability-adjusted life year rate are projected to continue declining through 2035. Sex- and age-stratified analyses revealed that age-specific incidence, prevalence, mortality, and disability-adjusted life year rates increased with age, peaking at 85-90 years. Males had higher rates at 84-94 years, but absolute cases, deaths and disability-adjusted life years were higher in females after 70 years.</p><p><strong>Conclusions: </strong>GBTC burden in BRI countries varies by regions, SDI, temporal trends, and demographic factors. While overall burden declines, addressing healthcare disparities, environmental risks, and early detection gaps is crucial in high-burden countries and populations. Strengthening collaboration among BRI countries is key to mitigating GBTC burden and advancing public health initiatives.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jian-Yong Zhuo , Hui-Gang Li , Pei-Ru Zhang , Di Lu , Xiao Xu
{"title":"The advances in the diagnosis and treatment of CK19-positive hepatocellular carcinoma","authors":"Jian-Yong Zhuo , Hui-Gang Li , Pei-Ru Zhang , Di Lu , Xiao Xu","doi":"10.1016/j.hbpd.2025.08.003","DOIUrl":"10.1016/j.hbpd.2025.08.003","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 473-475"},"PeriodicalIF":4.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuan Zhuang , Yi-Feng He , Dan-Xue Zheng , Shi-Suo Du , Gen-Lai Lin , Qian-Qian Zhao , Zhao-Chong Zeng , Yi-Xing Chen
{"title":"Safety and efficacy of hypofractionated radiotherapy combined with tyrosine kinase inhibitors in patients with lung metastases after liver transplantation for hepatocellular carcinoma","authors":"Yuan Zhuang , Yi-Feng He , Dan-Xue Zheng , Shi-Suo Du , Gen-Lai Lin , Qian-Qian Zhao , Zhao-Chong Zeng , Yi-Xing Chen","doi":"10.1016/j.hbpd.2025.07.003","DOIUrl":"10.1016/j.hbpd.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Lung metastases often occur after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). This study aimed to evaluate the safety and efficacy of combining hypofractionated radiotherapy (HFRT) with tyrosine kinase inhibitors (TKIs) in patients with lung metastases from HCC following OLT.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed forty-eight patients with lung metastases post-OLT for HCC, who underwent concurrent HFRT and TKIs between July 2011 and August 2022. The primary endpoint was progression-free survival (PFS), and secondary endpoints included overall survival (OS), local control rate (LCR), in-field objective response rate (ORR), and treatment-related side effects.</div></div><div><h3>Results</h3><div>The median follow-up duration was 42.3 months, with median PFS and OS of 9.9 and 32.7 months, respectively. PFS rates at 1, 2, and 3 years were 33.3%, 20.8%, and 12.5%, respectively, whereas corresponding OS rates were 91.7%, 70.8%, and 33.3%, respectively. Independent adverse factors for PFS included the presence of > 3 lung metastases, interval time from OLT to lung metastasis < 1 year, and post-HFRT lymphocyte nadir < 0.8 × 10<sup>9</sup>/L. For OS, independent adverse factors included shorter PFS time, shorter intervals from OLT to lung metastasis, and post-HFRT lymphocyte nadirs < 0.8 × 10<sup>9</sup>/L. The 1- and 2-year LCRs for lung metastases were 100% and 85.3%, respectively. The best in-field ORR was 95.5%, with no adverse events exceeding grade 2. Radiation pneumonitis occurred in 32 patients (66.7%), with grade 1 in 28 patients (58.3%) and grade 2 in 4 patients (8.3%).</div></div><div><h3>Conclusions</h3><div>The combination of HFRT with TKIs is a feasible, safe, and promising approach for treating lung metastases from HCC post-OLT.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 484-490"},"PeriodicalIF":4.4,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictive factors of postoperative ascites after laparoscopic pancreaticoduodenectomy for periampullary carcinoma.","authors":"Chuan-Zhi Tang, Zhong-Jun Wu, Da-Di Peng","doi":"10.1016/j.hbpd.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic pancreaticoduodenectomy (LPD) has gained growing acceptance for the resection of periampullary carcinoma. However, postoperative ascites (POA) frequently occurs after LPD, yet little is known about the underlying factors that promote POA under this laparoscopic approach. This study aimed to explore the clinical influence of POA after LPD and its potential predictors.</p><p><strong>Methods: </strong>Patients diagnosed with periampullary carcinoma who subsequently underwent LPD from December 2015 to February 2023 were reviewed. Patients were assigned to the two groups by whether daily abdominal drainage > 500 mL for at least three consecutive days, followed by subgroup analysis of pancreatic fistula (PF)-POA and non-PF-POA. Variables, including preoperative laboratory tests, past history, surgery-related factors, and incidence of complications, were compared. In addition, logistic regression analysis was applied to reveal the potential independent risk factors for PF-POA and non-PF-POA.</p><p><strong>Results: </strong>A total of 38 patients (17.4 %) developed POA, with 17 having PF-POA and 21 having non-PF-POA. Patients with grade B PF-POA experienced a higher incidence of intra-abdominal infection, and a longer hospital stay compared with other groups. Multivariate analysis demonstrated that prothrombin time > 14 s and main pancreatic duct diameter < 3 mm were independent risk factors for PF-POA. Moreover, male sex, total bilirubin > 34.2 μmol/L and platelet count < 100 × 10<sup>9</sup>/L were independent risk factors for non-PF-POA. The areas under the receiver operating characteristic curve were 0.682 and 0.786 for predicting PF-POA and non-PF-POA, respectively.</p><p><strong>Conclusions: </strong>LPD recovery and postoperative complications are impacted by POA, where PF-POA is the most clinically relevant POA. Prolonged prothrombin time and narrowed main pancreatic duct were independent risk factors for PF-POA; male sex, elevated total bilirubin level, and decreased platelet count were independent risk factors for non-PF-POA.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of immunosuppressive therapy for autoimmune hepatitis patients with cirrhosis unsuitable for biopsy","authors":"Lin Wang , Dong-Ying Ji , Ji-Dong Jia","doi":"10.1016/j.hbpd.2025.08.001","DOIUrl":"10.1016/j.hbpd.2025.08.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 570-575"},"PeriodicalIF":4.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}