ArticleJournal of hepatocellular carcinoma2026
Association of Combined Iodine-125 Seed Implantation and Atezolizumab/Bevacizumab with Improved Outcomes in Recurrent Hepatocellular Carcinoma After Hepatectomy: A Comparative Retrospective Analysis.
Article in Journal of hepatocellular carcinoma, 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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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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Abstract
Purpose: This study evaluated whether combining Iodine-125 (125I) seed implantation with atezolizumab and bevacizumab (Atezo/Bev) improves outcomes compared to Atezo/Bev alone in patients with recurrent HCC after hepatectomy. Methods: This retrospective comparative analysis included patients with recurrent HCC after hepatectomy treated between January 2020 and December 2025. Patients were divided into a Combination Group (125I seed implantation plus Atezo/Bev, n=79) and a Control Group (Atezo/Bev alone, n=94). To minimize selection bias, propensity score matching (PSM) was performed using a 1:1 nearest-neighbor algorithm, yielding 62 matched pairs. A 14-day landmark analysis was conducted to address immortal-time bias. Primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS), respectively. Tumor response was assessed by RECIST 1.1. Treatment effects were estimated using stratified Cox proportional hazards models with matched pairs as strata, and a multivariable stratified Cox model was performed as a sensitivity analysis. Results: After propensity score matching, 62 matched pairs were obtained with satisfactory covariate balance (all SMDs < 0.1). The Combination Group showed significantly higher objective response rate (63.3% vs 46.8%, Conclusion: In this retrospective comparative analysis, the addition of CT/ultrasound-guided 125I seed implantation to Atezo/Bev was associated with improved tumor response and survival outcomes compared to Atezo/Bev alone in patients with recurrent HCC after hepatectomy, with a manageable safety profile. These findings suggest a potential benefit of combining local brachytherapy with systemic immunotherapy, but causality cannot be established due to the observational design. Prospective randomized trials are warranted to confirm these results.
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