2026-10-14T21:48:46Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34012656 2026-09-28T09:44:36Z category_7 portal_147 item_type_3 month_year_09_2026

Supplemental Material for: The efficacy and safety of neoadjuvant therapy for resectable hepatocellular carcinoma with high recurrence risk: A multicenter real-world study figshare admin karger (2628495) Junshuai Xue (21582407) Xiao Chen (260187) Yefan Zhang (8734865) Wei He (131453) Jingzhong Ouyang (17256157) Rujiang Liu (25121509) Mingjian Piao (17862817) Hongli Yu (722739) Jiamin Cheng (12866848) Jiliang Qiu (6060869) Runze Yu (1516615) Jianping Chang (18323257) Zhewen Wei (25121513) Dayong Cao (188624) Weiping Ji (3119412) Zhiyu Li (10983) Jianguo Zhou (591555) Jianjun Zhao (296602) Xinyu Bi (591554) Zhen Huang (58276) Jianqiang Cai (299025) Sheng Tai (530095) Haitao Zhao (14023) Yinying Lu (718349) Binkui Li (5626859) Hong Zhao (325) Medicine Medicine <p dir="ltr">Introduction: The high recurrence rate of hepatocellular carcinoma (HCC) remains a clinical challenge, and reliable evidence supporting neoadjuvant therapy in resectable patients with high recurrence risk is lacking. This study aimed to evaluate the outcomes and safety of neoadjuvant therapy. Methods: This multicenter retrospective study included resectable HCC patients with high recurrence risks (single tumor >5 cm, multiple tumors without portal vein tumor thrombus [PVTT], or any tumor number/size with Vp1/Vp2 PVTT, but not Vp3/Vp4) who received short-course neoadjuvant therapy from five tertiary hospitals (2019-2023). Efficacy was assessed using RECIST v1.1/mRECIST, Kaplan-Meier survival analysis, and Cox regression. Safety was evaluated by CTCAE and Clavien-Dindo classification criteria. Endpoints included overall survival (OS), recurrence-free survival (RFS), objective response rate (ORR), disease control rate (DCR), and pathological responses. Results: Of 672 patients, 272 received neoadjuvant therapy and 400 underwent direct surgery; 328 remained after 1:1 propensity score matching. Neoadjuvant therapy (n=164) reduced mortality risk by 53% (HR=0.47, p=0.001) and recurrence risk by 40% (HR=0.60, p<0.001), with median RFS extended by 24.1 months. The exploratory subgroup analysis suggested that immunotherapy-based neoadjuvant therapy (n=116) was associated with improved outcomes compared to direct surgery (OS, HR=0.43, p=0.004; RFS, HR=0.60, p=0.007), only in male patients with HBV infection, multiple tumors, maximum tumor diameter ≤5 cm, CNLC stage IIb or BCLC stage B, and good liver function. In the full immunotherapy-based neoadjuvant group (n=212), ORR/DCR were 46.2%/98.1% (RECIST v1.1) and 73.6%/99.5% (mRECIST). The major pathological response (mPR) and pathological complete response (pCR) rates were 18.4% and 23.6%, respectively. No statistically significant difference was observed in Clavien-Dindo grade. Conclusion: Short-course, immunotherapy-based neoadjuvant therapy appears feasible and safe, and may be associated with improved survival in resectable HCC with high recurrence risk. However, these findings remain hypothesis-generating and require further exploration and validation in future prospective studies.</p> 2026-09-28T09:44:36Z Dataset Dataset 10.6084/m9.figshare.34012656.v1 https://figshare.com/articles/dataset/Supplemental_Material_for_The_efficacy_and_safety_of_neoadjuvant_therapy_for_resectable_hepatocellular_carcinoma_with_high_recurrence_risk_A_multicenter_real-world_study/34012656 CC BY 4.0