ArticleBMC cancer2023
Radiographic and α-fetoprotein response predict pathologic complete response to immunotherapy plus a TKI in hepatocellular carcinoma: a multicenter study.
Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Conversion hepatectomy and survival in initially unresectable hepatocellular carcinoma: a systematic review and meta-analysis with quantitative bias analysis.World journal of surgical oncology · 2026Pooled it
- Safety and efficacy of salvage surgery for unresectable hepatocellular carcinoma after conversion with triple therapy: a systematic review and meta-analysis of data from Chinese patients.World journal of surgical oncology · 2025Pooled it
- Non-surgery strategy versus hepatectomy in hepatocellular carcinoma patients with complete response after conversion therapy: a meta-analysis.World journal of surgical oncology · 2024Pooled it
- Response evaluation to systemic therapy in HCC: Current challenges and future perspectives.Hepatology (Baltimore, Md.) · 2026Review
- Deep learning-assisted tumor radiomic dynamics on MRI predict pathological complete response in HCC undergoing immune-based therapy followed by hepatectomy.Hepatology (Baltimore, Md.) · 2026Article
- Chinese expert consensus on conversion and perioperative therapy of primary liver cancer (2024 edition).Hepatobiliary surgery and nutrition · 2026Review
- Prognostic Value of Pathological Response After Conversion Therapy and Salvage Surgery in Unresectable Hepatocellular Carcinoma.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- A Real-World Experience of Prognostic Factors of Survival Outcomes in a Taiwanese Population With Unresectable Hepatocellular Carcinoma Treated With First-Line Lenvatinib.Cancer medicine · 2026Article
- Stable Disease without Tumor Shrink Cannot Benefit from Surgery following Immune-Based Therapy in Potentially Resectable Hepatocellular Carcinoma.Liver cancer · 2026Article
- When Resectability Emerges After Systemic Therapy in Hepatocellular Carcinoma: A Proposed Response-Guided Consolidation Framework.Journal of hepatocellular carcinoma · 2026Review
- Discontinuing Immune Checkpoint Inhibitor-Based Therapy After Complete Response in Unresectable Hepatocellular Carcinoma: Evidence, Bias, and a Research Framework.Journal of hepatocellular carcinoma · 2026Review
- From anatomical to biological resectability: navigating adaptive resistance in hepatocellular carcinoma conversion.Frontiers in oncology · 2026Review
- Pathologic Complete Response to Neoadjuvant Dual Checkpoint Blockade with Durvalumab Plus Tremelimumab in Advanced-Stage HCC: A Case Report.Journal of hepatocellular carcinoma · 2026Article
- Are we overestimating success of salvage hepatectomy in unresectable hepatocellular carcinoma?World journal of clinical oncology · 2025Article
- CRAFITY and AFP/PIVKA-II Kinetics Predict Prognosis in Hepatocellular Carcinoma on Immunotherapy.Cancers · 2025Article
- Prognostic Impact of the Pathologic Response of Patients with Hepatocellular Carcinoma After Preoperative Treatments.Annals of surgical oncology · 2025Article
- Trajectories of α-fetoprotein and unresectable hepatocellular carcinoma outcomes receiving lenvatinib: a retrospective, multicenter cohort study.BMC cancer · 2025Article
- Article
- The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy.Biomarker research · 2025Article
- Prediction of Pathologic Response in Unresectable Hepatocellular Carcinoma After Downstaging with Locoregional and Systemic Combination Therapy.Journal of hepatocellular carcinoma · 2025Article
Corrections and comments
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Authors and funding
25 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPathologic complete response (pCR) following preoperative systemic therapy is associated with improved outcomes after subsequent liver transplant/resection in hepatocellular carcinoma (HCC). However, the relationship between radiographic and histopathological response remains unclear.
methodsWe retrospectively examined patients with initially unresectable HCC who received tyrosine kinase inhibitor (TKI) plus anti-programmed death 1 (PD-1) therapy before undergoing liver resection between March 2019 and September 2021 across 7 hospitals in China. Radiographic response was evaluated using mRECIST. A pCR was defined as no viable tumor cells in resected samples.
resultsWe included 35 eligible patients, of whom 15 (42.9%) achieved pCR after systemic therapy. After a median follow-up of 13.2 months, tumors recurred in 8 non-pCR and 1 pCR patient. Before resection, there were 6 complete responses, 24 partial responses, 4 stable disease cases, and 1 progressive disease case, per mRECIST. Predicting pCR by radiographic response yielded an area under the receiver operating characteristic curve (AUC) of 0.727 (95% CI: 0.558-0.902), with an optimal cutoff value of 80% reduction in the enhanced area in MRI (called major radiographic response), which had a 66.7% sensitivity, 85.0% specificity, and a 77.1% diagnostic accuracy. When radiographic response was combined with α-fetoprotein response, the AUC was 0.926 (95% CI: 0.785-0.999); the optimal cutoff value was 0.446, which had a 91.7% sensitivity, 84.6%, specificity, and an 88.0% diagnostic accuracy.
conclusionsIn patients with unresectable HCC receiving combined TKI/anti-PD 1 therapy, major radiographic response alone or combined with α-fetoprotein response may predict pCR.
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