Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Combined Transarterial Chemoembolization and External Beam Radiotherapy for Identifying Surgical Candidates for Hepatocellular Carcinoma with Macroscopic Vascular Invasion: A Propensity Score–Weighted Analysis: Sumin Lee, Jinhong Jung, Jonggi Choi, So Yeon Kim, Jin Hyoung Kim, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim, Han Chu Lee, Gi-Won Song, Jin-hong Park, Sang Min Yoon; Cancer Res Treat. 2026;58(1):275-283. Published online May 22, 2025; DOI: https://doi.org/10.4143/crt.2025.076

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the role of hepatic resection in patients with objective responses after combined transarterial chemoembolization (TACE) and radiotherapy (RT) for hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI).
Materials and Methods
We retrospectively reviewed the patients treated with combined TACE and RT for HCC with MVI between 2010 and 2015. Some of the patients with objective responses underwent hepatic resection or liver transplantation; to investigate the impact of surgery, patients with objective responses who did not undergo surgery were selected as the control group. Survival outcomes were compared using a propensity score–based stabilized inverse probability of treatment weighting method.
Results
Out of the 170 patients with objective responses after combined TACE and RT, 41 patients underwent surgery, including eight liver transplantations. The unweighted surgery group was younger and had a higher proportion of solitary tumors and unilateral vascular involvement. After adjustment, the 3-year overall survival (OS) rates were 61.0% and 28.6% in the surgery and non-surgery groups, respectively. The most important prognostic factor for OS was surgery (adjusted Cox hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.17 to 0.46; p < 0.001). Complete response after TACE and RT (vs. partial response) was also a significant prognostic factor for OS (adjusted HR, 0.41; 95% CI, 0.27 to 0.61; p < 0.001). There was no surgical mortality. Four patients (9.8%) required additional surgery due to bleeding or graft failure.
Conclusion
Hepatic resection was significantly associated with improved OS in patients who showed objective responses after receiving combined TACE and RT for HCC with MVI.

Citations

Citations to this article as recorded by

Multimodal deep learning model for predicting prognosis following radiotherapy-based combination therapy in unresectable hepatocellular carcinoma
Haoming Xia, Qizhen Huang, Ziyue Huang, Ziqi Zhou, Yongyi Zeng, Jingguang Ma, Xiangyu Fan, Yechong Huang, Yuexi Dong, Haitao Zhao, Gong Li, Jitao Wang, Shizhong Yang, Jiahong Dong
Cancer Letters.2026; 636: 218122. CrossRef

1,404 View
62 Download
1 Web of Science
1 Crossref

Clinical and Radiologic Predictors of Response to Atezolizumab-Bevacizumab in Advanced Hepatocellular Carcinoma: Se Jin Choi, Sung Won Chung, Jonggi Choi, Kang Mo Kim, Hyung-Don Kim, Changhoon Yoo, Baek-Yeol Ryoo, Seung Soo Lee, Won-Mook Choi, Sang Hyun Choi; Cancer Res Treat. 2024;56(4):1219-1230. Published online May 7, 2024; DOI: https://doi.org/10.4143/crt.2024.283

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to identify clinical and radiologic characteristics that could predict response to atezolizumab-bevacizumab combination therapy in patients with advanced hepatocellular carcinoma (HCC).
Materials and Methods
This single-center retrospective study included 108 advanced HCC patients with intrahepatic lesions who were treated with atezolizumab-bevacizumab. Two radiologists independently analyzed imaging characteristics of the index tumor on pretreatment computed tomography. Predictive factors associated with progressive disease (PD) at the best response based on Response Evaluation Criteria in Solid Tumors, ver. 1.1 were evaluated using logistic regression analysis. Progression-free survival (PFS) was estimated by the Kaplan-Meier method and compared with the log-rank test.
Results
Of 108 patients with a median PFS of 15 weeks, 40 (37.0%) had PD during treatment. Factors associated with PD included the presence of extrahepatic metastases (adjusted odds ratio [aOR], 4.13; 95% confidence interval [CI], 1.19 to 14.35; p=0.03), the infiltrative appearance of the tumor (aOR, 3.07; 95% CI, 1.05 to 8.93; p=0.04), and the absence of arterial-phase hyperenhancement (APHE) (aOR, 6.34; 95% CI, 2.18 to 18.47; p < 0.001). Patients with two or more of these factors had a PD of 66.7% and a median PFS of 8 weeks, indicating a significantly worse outcome compared to the patients with one or no of these factors.
Conclusion
In patients with advanced HCC treated with atezolizumab-bevacizumab treatment, the absence of APHE, infiltrative appearance of the intrahepatic tumor, and presence of extrahepatic metastases were associated with poor response and survival. Evaluation of early response may be necessary in patients with these factors.

Citations

Citations to this article as recorded by

Integrative multi-omics profiling identifies infiltrative hepatocellular carcinoma as an immunotherapy-resistant subtype with distinct molecular features
Won Suk Lee, Seonjeong Woo, Sung Hwan Lee, Gae Hoon Jo, Ilhwan Kim, Hyeyeong Kim, Chansik An, Sanghoon Jung, Gwangil Kim, Haeyoun Kang, Beodeul Kang, Jung Sun Kim, Ho Yeong Lim, Incheon Kang, Hannah Yang, So Jung Kong, Dahyeon Son, Dong Jun Shin, Woo Youn
Clinical and Molecular Hepatology.2026; 32(1): 258. CrossRef
Transarterial chemoembolization combined with immune checkpoint inhibitors and anti-VEGF agents for intermediate HCC: a multicenter study
Wei-Yi Jiang, Jin-Kai Feng, Bin Zhou, Si-Si Ren, Yu-Chao Hou, Fang-Fang Zhang, Yan-Jun Xiang, Zong-Han Liu, Rong-Chen Chen, Yun-Feng Shan, Chao Liang, Hong-Kun Zhou, Lin Gong, Shu-Qun Cheng
European Journal of Surgical Oncology.2026; 52(3): 111407. CrossRef
Application of imaging modalities in predicting and evaluating response to anti-vascular endothelial growth factor agents and immune checkpoint inhibitors in patients with hepatocellular carcinoma
Li-Ping Zhou, Wei Yang
World Chinese Journal of Digestology.2025; 33(6): 441. CrossRef
Clinical Significance of Intratumoral Contrast Pooling on Contrast-Enhanced CT After Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma
Kiyoyuki Minamiguchi, Mariko Irizato, Ryota Nakano, Hideki Kunichika, Tetsuya Tachiiri, Ryosuke Taiji, Yuki Tsuji, Satoshi Yasuda, Hitoshi Yoshiji, Masayuki Sho, Toshihiro Tanaka
Current Oncology.2025; 32(12): 694. CrossRef
Liver Transplantation for Hepatocarcinoma: Results over Two Decades of a Transplantation Programme and Analysis of Factors Associated with Recurrence
María Martínez Burgos, Rocío González Grande, Susana López Ortega, Inmaculada Santaella Leiva, Jesús de la Cruz Lombardo, Julio Santoyo Santoyo, Miguel Jiménez Pérez
Biomedicines.2024; 12(6): 1302. CrossRef

4,066 View
165 Download
4 Web of Science
5 Crossref

First
Prev
Page of 1
Next
Last

Search