Conversion Resection or Direct Resection for Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicentre Study

作者：Ying Zhou, Haiqing Wang, Jiayi Wu, Junyi Shen, Ji Ma, Q. Li, Weixia Chen, Wusheng Lu, Xielin Feng, Mao-Lin Yan, Tianfu Wen, Xiaoyun Zhang · 发表于：Liver Cancer · 年份：2025 · DOI：10.1159/000549684 · 被引用次数：2 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes、Cholangiocarcinoma and Gallbladder Cancer Studies

Introduction: The majority of patients with hepatocellular carcinoma (HCC) are diagnosed at an intermediate stage, and current treatment options are associated with unfavourable overall prognosis. This study aimed to evaluate the efficacy of conversion therapy before resection compared with direct resection or comprehensive therapy alone in patients with intermediate-stage HCC, with a focus on pathological responses and long-term outcomes. Methods: In this multicentre study, 248 patients diagnosed with intermediate-stage HCC between January 2020 and December 2023 were enrolled. Of these, 56 patients received preoperative conversion therapy followed by resection (conversion resection group), 162 underwent direct resection (direct resection group), and 30 received comprehensive therapy alone and did not undergo surgical resection (comprehensive therapy group). Propensity score matching was performed to balance the baseline characteristics, and pathological responses were systematically evaluated. Results: Among conversion resection group, 13 patients (23.2%) achieved a pathological complete response, and 29 (51.8%) achieved a major pathological response. The conversion resection group exhibited significantly lower microvascular invasion rates (17.9% vs. 58.6%, p < 0.001) and higher tumour differentiation grades (p < 0.001). The median recurrence-free survival (RFS) was markedly improved in the conversion resection group (not reached vs. 12.3 months, p < 0.001), with 3-...