Survival benefit of hepatectomy after complete or partial response to conversion therapy in unresectable hepatocellular carcinoma (GUIDANCE003): a multi-center study

作者：Da-Long Yang, Ning Peng, Jun-Liang Nong, Kang Chen, Ze Su, Yaqun Yu, Lin Ye, Fan-Jian Zeng, Shaoping Liu, Yi-He Yan, Xueyao Wang, Hongbing Yao, Fuquan Yang, Wenfeng Li, Chuang Qin, Ming-Song Wu, Yong‐Yu Yang, Xiaofeng Dong, Mian-Jing Li, Jie Liu, Yong-Rong Liang, Pei‐Sheng Wu, Teng-Meng Zhong, Yongrong Lai, Yao-Zhi Chen, Qingqing Pang, Guo-Dong Wang, Fu-Xin Li, X H Mao, Shuchang Chen, Jun‐Jie Ou, Rong‐Rui Huo, Xiumei Liang, Bang‐De Xiang, Liang Ma, Jian‐Hong Zhong, on behalf of the GUIDANCE investigators · 发表于：Liver Cancer · 年份：2025 · DOI：10.1159/000546052 · 被引用次数：6 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Cancer Mechanisms and Therapy

Introduction: Uncertainty exists regarding whether hepatectomy enhances the prognosis for initially unresectable hepatocellular carcinoma (HCC) that becomes resectable subsequent to conversion therapy. This study conducted a comparative analysis of survival rates between patients who underwent hepatectomy and those who did not, following complete or partial response to conversion therapy. Methods: This retrospective study examined 300 patients with HCC who underwent hepatectomy following conversion therapy, along with 265 nonsurgical control subjects (215 receiving locoregional/systemic therapy and 50 under active surveillance) across 20 Chinese medical centers from 2019 to 2023. The primary outcomes assessed included overall survival (OS), event-free survival (EFS), recurrence-free survival, and the rate of complete pathological response. Results: = 0.403). These results were confirmed after analyzing subgroups matched to each other based on propensity scoring. Among patients who underwent hepatectomy, those who responded completely to conversion therapy showed significantly better OS than those who responded partially (HR: 0.40, 95% CI: 0.21-0.75) as well as significantly better EFS (HR: 0.45, 95% CI: 0.29-0.70). Among patients who did not undergo hepatectomy, OS and EFS were comparable between those who responded partially and those who responded completely to conversion therapy. Additionally, locoregional or systemic therapy showed significantly better results in terms of...