ArticleJournal of advanced research2026
Vessels encapsulating tumor clusters is associated with impaired efficacy of adjuvant immunotherapy in resected hepatocellular carcinoma.
Article in Journal of advanced research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is PD-1/PD-L1 inhibitor plus bevacizumab superior to sorafenib as first-line treatment for advanced hepatocellular carcinoma? A pooled analysis of four phase 3 RCTs.BMC gastroenterology · 2026Pooled it
- Vessels encapsulating tumor clusters predict better outcomes in advanced hepatocellular carcinoma treated with atezolizumab-bevacizumab.JHEP reports : innovation in hepatology · 2026Article
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17 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionAggressive pathologic features are closely associated with early recurrence of hepatocellular carcinoma (HCC), and the association between vessels encapsulating tumor clusters (VETC) and poor prognosis has received increasing attention.
objectivesThis study aimed to investigate the role of adjuvant Sintilimab (AS) with or without Lenvatinib (ASL) compared to active monitoring (AM) in high-risk HCC, with emphasis on VETC-positive subtypes.
methodsPatients identified as being at high risk for recurrence and who had undergone either AM, AS, or ASL were retrospectively enrolled from four medical centers. Propensity score matching (PSM) was adopted to minimize bias. Digital spatial profiling (DSP) and multiplex immunofluorescence (mIF) were employed to elucidate the molecular underpinnings of VETC-positive HCC.
resultsThis study included 620 patients with a median follow-up of 46.9 months. After PSM, 135 patients were allocated to each cohort. Both the AS and ASL regimens significantly prolonged median disease-free survival compared to AM (26.0 and 59.2 months vs. 12.2 months, respectively; p < 0.001). Critically, subgroup analysis revealed that the benefit of AS was absent in VETC-positive HCC (p = 0.681), whereas ASL demonstrated a substantial reduction in recurrence (p = 0.001). This specific efficacy of Lenvatinib against VETC-positive HCC was further corroborated by data from first-line treatment for recurrent disease and an independent neoadjuvant therapy cohort. Mechanistically, DSP revealed that VETC-positive tumors possess an immunosuppressive microenvironment, characterized by downregulated antigen presentation and impoverished CD8+ T cell infiltration. This immune contexture was validated by mIF, which confirmed sparse CD8+ T cells alongside enriched CD4+ and regulatory T cells in VETC-positive HCC.
conclusionsThis study validates VETC-positive HCC as a distinct entity with a high risk of postoperative recurrence and validates the combination of PD-1 inhibitors with Lenvatinib as its preferred therapeutic strategy.
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