{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:55:36Z","timestamp":1790657736007,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>The optimal treatment strategy for patients with intermediate\u2010stage hepatocellular carcinoma beyond the up\u2010to\u2010seven criteria (Barcelona Clinic Liver Cancer B2) remains uncertain. Although transarterial chemoembolization has long been the standard of care, its efficacy is limited in this subgroup, and systemic therapies have recently been introduced. We aimed to explore treatment modalities associated with survival beyond that predicted by a previously validated prognostic model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 113 patients diagnosed with BCLC\u2010B2 stage hepatocellular carcinoma between 2017 and 2024. Predicted survival was calculated using a previously established prognostic model, and treatment benefits were evaluated by comparing observed survival with predicted outcomes. Logistic and linear regression analyses were performed to identify factors associated with survival gain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median observed survival was 26.0\u2009months, compared with a model\u2010predicted survival of 24.7\u2009months. Treatment with atezolizumab plus bevacizumab was significantly associated with survival exceeding model predictions (odds ratio: 3.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0065). Linear regression analysis confirmed that atezolizumab plus bevacizumab was independently associated with a greater survival benefit (\u03b2\u2009=\u20090.192,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0084). Subgroup analysis demonstrated that this association was particularly pronounced in patients with high tumor burden (tumor number plus size \u2265\u200911), whereas no significant associations were observed for lenvatinib, STRIDE, or cabozantinib.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Atezolizumab plus bevacizumab was associated with survival beyond that predicted by a prognostic model in patients with BCLC\u2010B2 stage hepatocellular carcinoma, particularly those with high tumor burden. These findings should be considered exploratory and associative rather than evidence of a causal treatment effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70765","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:11:41Z","timestamp":1790655101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atezolizumab Plus Bevacizumab Treatment for Patients With Hepatocellular Carcinoma in the Barcelona Clinic Liver Cancer B2 Stage"],"prefix":"10.1111","author":[{"given":"Keishi","family":"Ouchi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Tohoku University Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6154-8075","authenticated-orcid":false,"given":"Masashi","family":"Ninomiya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7693-3505","authenticated-orcid":false,"given":"Mio","family":"Tsuruoka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-7835","authenticated-orcid":false,"given":"Jun","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Hospital  Sendai Japan"},{"name":"Institute for Excellence in Higher Education Tohoku University  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital  Matsuyama Ehime 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Shiwa Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Fukushima Medical University School of Medicine  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-9465","authenticated-orcid":false,"given":"Kazumichi","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Fukushima Medical University School of Medicine  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Katsumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Yamagata University Faculty of Medicine  Yamagata 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J.","year":"2015","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1159\/000452846","article-title":"Albumin\u2010Bilirubin (ALBI) Grade as Part of the Evidence\u2010Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison With the Liver Damage and Child\u2010Pugh Classifications","volume":"6","author":"Hiraoka A.","year":"2017","journal-title":"Liver Cancer"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70765","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.70765","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70765","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:11:45Z","timestamp":1790655105000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.70765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":21,"alternative-id":["10.1111\/jgh.70765"],"URL":"https:\/\/doi.org\/10.1111\/jgh.70765","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-03-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jgh.70765"}}