Evidence map›Paper›PMID 40019708›Full record

ArticleHepatology international2025

The benefit of conversion therapy for patients with unresectable hepatocellular carcinoma receiving atezolizumab plus bevacizumab using newly established oncological resectability criteria in Japan.

Shigeo Shimose, Issei Saeki, Takanori Ito, Yasuto Takeuchi, Joji Tani, Tetsu Tomonari, Ryu Sasaki, Kyo Sasaki, Satoru Kakizaki, Takeshi Hatanaka and 14 more

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Article in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors.

Shigeo ShimoseDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan. shimose_shigeo@med.kurume-u.ac.jp.ORCID http://orcid.org/0000-0003-2068-8386
Issei SaekiDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Takanori ItoDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yasuto TakeuchiDepartment of Gastroenterology, Okayama University Hospital, Okayama, Japan.
Joji TaniDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu, Japan.
Tetsu TomonariDepartment of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School of Medicine, Tokushima, Japan.
Ryu SasakiDepartment of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Kyo SasakiDepartment of Gastroenterology and Hepatology, Kawasaki Medical School, Kurashiki, Japan.
Satoru KakizakiDepartment of Clinical Research, NHO Takasaki General Medical Center, Takasaki, Gunma, Japan.
Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Hideki IwamotoDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
Norikazu TanabeDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Takafumi YamamotoDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Atsushi NaganumaDepartment of Clinical Research, NHO Takasaki General Medical Center, Takasaki, Gunma, Japan.
Tomotake ShironoDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
Yuki KanayamaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Sohji NishinaDepartment of Gastroenterology and Hepatology, Kawasaki Medical School, Kurashiki, Japan.
Tetsuji TakayamaDepartment of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School of Medicine, Tokushima, Japan.
Hideki KobaraDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Takamatsu, Japan.
Motoyuki OtsukaDepartment of Gastroenterology, Okayama University Hospital, Okayama, Japan.
Hiroki KawashimaDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Taro TakamiDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Takumi KawaguchiDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
representing the Hepatology InVestigator Experts in Japan (HIVE-J) Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to investigate the changes in oncological resection status in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev) and the impact of conversion therapy following Atez/Bev treatment.

methodsThis cohort included 631 patients with u-HCC treated with Atez/Bev. Tumors were assessed using oncological resectability criteria and categorized as borderline resectable 1 (BR1, n=166) or borderline resectable 2 (BR2, n=465).

resultsOverall, 129 (20.4%) patients were downstaged based on oncological resectability criteria. Among them, 28 (16.8%) patients were downstaged from BR1 to resectable (R), and 49 (10.5%) and 52 (11.1%) patients were downstaged from BR2 to R and from BR2 to BR1, respectively. The percentage of patients who underwent conversion therapy was 5.4%. For patients categorized as BR1 and BR2 before Atez/Bev treatment, the rates of conversion therapy were 8.4% (14/166) and 4.3% (20/465), respectively. Overall survival (OS) was significantly higher in the conversion therapy group than in the partial response group (not reached vs. 36.4 months, p=0.001), with no significant differences compared to the complete response group. The median recurrence-free survival was 15.7 months after conversion therapy. Although there were differences in patient background data at the time of conversion therapy, surgery had a significantly higher RFS than radiofrequency ablation (not reached vs. 10.0 months, p=0.008).

conclusionsWhen feasible, conversion therapy should be considered to improve the prognosis of u-HCC patients treated with Atez/Bev. Moreover, oncological resectability criteria may provide a useful tool for investigators regarding conversion therapy.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, HepatocellularLiver NeoplasmsAgedFemaleHepatectomyHumansJapanMaleMiddle AgedRetrospective StudiesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabAtezolizumab plus bevacizumabConversion therapyHepatocellular carcinomaOncological resectability criteria

Identifiers

PMID40019708

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.