{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:25:42Z","timestamp":1786951542083,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with hepatocellular carcinoma (HCC) awaiting liver transplantation remain at risk of tumor progression during the waiting period, highlighting the need for effective bridging or downstaging strategies. Although tyrosine kinase inhibitors (TKIs) are widely used in advanced HCC, their role in the pre\u2010transplant setting remains unclear. This study evaluated the association of pre\u2010transplant TKI therapy with survival, tumor response, and safety in HCC patients undergoing liver transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 427 patients with HCC who underwent orthotopic liver transplantation (OLT) between January 2015 and December 2024. Two separate propensity score matching (PSM) analyses were performed to compare outcomes between patients with and without pre\u2010transplant TKI therapy, and to evaluate the additional association of TKIs among patients receiving transarterial chemoembolization (TACE). Primary outcomes were overall survival (OS) and recurrence\u2010free survival (RFS). Tumor response and safety were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After PSM, 160 matched patients were included in the primary analysis. Pre\u2010transplant TKI therapy was associated with longer RFS (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) and lower recurrence rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007), greater pathological tumor necrosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and higher radiological response rates (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Higher 5\u2010 and 10\u2010year OS and RFS rates were also observed in the TKIs group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). On multivariable analysis, pre\u2010transplant TKI therapy remained associated with lower recurrence risk but not OS. Exploratory subgroup analyses suggested that these associations were more evident in patients beyond conventional transplant criteria. Among 120 matched patients receiving TACE, combined TACE and TKI therapy was associated with better survival and tumor response (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Palmar\u2010plantar erythrodysesthesia occurred more frequently in the TKIs group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.035), whereas major perioperative complications were comparable between groups, although ICU stay was slightly longer in the TKIs group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre\u2010transplant TKI therapy, particularly when combined with TACE, was associated with better tumor response and favorable long\u2010term outcomes without an apparent increase in major perioperative risk. These associations appeared more evident in patients beyond conventional transplant criteria. Prospective studies are needed to further validate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>This study was registered with ClinicalTrials.gov (registry number NCT07418138)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70454","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:05:15Z","timestamp":1783584315000},"page":"2421-2433","source":"Crossref","is-referenced-by-count":0,"title":["Association of Pre\u2010Transplant Tyrosine Kinase Inhibitor Therapy With Tumor Response and Survival in Hepatocellular Carcinoma: A 10\u2010Year Retrospective Cohort Study of 427 Patients"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1928-8506","authenticated-orcid":false,"given":"Lexuan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary 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