Evidence map›Paper›PMID 42448977›Full record

ArticleAnnals of surgical oncology2026

Prognostic Benefit of Sequential Locoregional Interventions During First-Line Systemic Therapy for Hepatocellular Carcinoma: Insights from Interaction Analysis of Lenvatinib and Atezolizumab/Bevacizumab.

Junichi Shindoh, Yusuke Kawamura, Tetsuya Hosaka, Takuma Okada, Satoshi Okubo, Masaru Matsumura, Norio Akuta

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

2 · The registry

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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

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Junichi ShindohHepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan. shindou-tky@umin.ac.jp.
Yusuke KawamuraDepartment of Hepatology, Toranomon Hospital, Tokyo, Japan.
Tetsuya HosakaDepartment of Hepatology, Toranomon Hospital, Tokyo, Japan.
Takuma OkadaHepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Satoshi OkuboHepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Masaru MatsumuraHepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Norio AkutaDepartment of Hepatology, Toranomon Hospital, Tokyo, Japan.

Funding

Okinaka Memorial Institute for Medical Research 2025
6 · The paper itself

Abstract

backgroundAchieving conversion therapy for advanced hepatocellular carcinoma (HCC) is a promising strategy. However, it remains unclear whether the prognostic impact of these interventions differs depending on the first-line systemic regimen. PATIENTS AND

methodsWe retrospectively analyzed 189 patients with advanced HCC who received first-line systemic therapy. Independent prognostic factors for overall survival (OS) were identified using Firth's penalized Cox proportional hazards models. Interaction analysis was performed to assess whether the benefit of interventions varied by regimen.

resultsInterventions were significantly associated with improved OS in the entire cohort. Notably, achieving R0 status provided the most substantial survival benefit, with no significant interaction between regimens (P = 0.425; hazard ratio [HR] 0.074 for lenvatinib, HR 0.406 for atezolizumab/bevacizumab). Transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) was also associated with improved OS, showing a more pronounced benefit in the lenvatinib group than in the atezolizumab/bevacizumab group (P = 0.105; HR 0.350 versus 0.726).

conclusionsAchieving R0 status through conversion therapy is a universal goal for maximizing OS, regardless of the initial systemic regimen. Lenvatinib may offer a more favorable platform for sequential TACE/HAIC to prolong overall survival compared to atezolizumab/bevacizumab.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, HepatocellularChemoembolization, TherapeuticLiver NeoplasmsAgedAntibodies, Monoclonal, HumanizedBevacizumabCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedPhenylurea CompoundsPrognosisQuinolinesAntibodies, Monoclonal, HumanizedatezolizumabBevacizumablenvatinibPhenylurea CompoundsQuinolinesConversionHepatocellular carcinomaSurgerySystemic chemotherapyTACE

Identifiers

PMID42448977

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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.