{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:26:04Z","timestamp":1789230364093,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100017686","name":"Fujian Provincial Health Technology Project","doi-asserted-by":"publisher","award":["2023CXA029"],"award-info":[{"award-number":["2023CXA029"]}],"id":[{"id":"10.13039\/501100017686","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>To evaluate the prognostic significance of pathological response in patients with initially unresectable hepatocellular carcinoma (uHCC) who underwent salvage resection after successful conversion with lenvatinib, anti\u2010PD\u20101 antibodies, and locoregional therapy (LPLRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included 102 uHCC patients who achieved curative resection after LPLRT across four tertiary centers in China. Residual viable tumour (pRVT) ratio was used to assess pathological response. Optimal pRVT cutoffs for overall survival (OS) and recurrence\u2010free survival (RFS) were identified using X\u2010tile (a statistical tool that identifies optimal prognostic cutoff values for continuous variables by systematically maximizing the log\u2010rank statistic). Survival was analysed by Kaplan\u2013Meier and log\u2010rank tests, and prognostic factors by Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 102 patients, 25 (24.5%) achieved pathological complete response (pCR). X\u2010tile identified pRVT thresholds of 10% and 35% as optimal for predicting OS and RFS, respectively. Patients with pRVT\u2009\u2264\u200910% had superior OS (1\u2010, 2\u2010, 3\u2009year: 96.6%, 89.8%, 82.5%) compared with pRVT\u2009&gt;\u200910% (95.5%, 73.0%, 49.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). pRVT\u2009\u2264\u200935% was associated with longer RFS (1\u2010, 2\u2009year: 60.5%, 47.1% vs. 24.0%, 10.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Similar trends persisted after excluding pCR cases. On multivariate analysis, NLR &lt;\u20092.6, adjuvant therapy, and pRVT\u2009\u2264\u200910% independently predicted improved OS, while age &lt;\u200960\u2009years was adverse for RFS, and NLR\u2009&lt;\u20092.6 and pRVT\u2009\u2264\u200935% were independently associated with prolonged RFS. No clinical variables predicted pRVT thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>pRVT refines postoperative prognostic assessment in uHCC after multimodal conversion therapy. Thresholds of \u2264\u200910% for OS and \u2264\u200935% for RFS serve as practical cutoffs for postoperative risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70681","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:30:51Z","timestamp":1779082251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Value of Pathological Response After Conversion Therapy and Salvage Surgery in Unresectable Hepatocellular Carcinoma"],"prefix":"10.1111","volume":"46","author":[{"given":"Qi\u2010Yu","family":"Chi","sequence":"first","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Institute of Abdominal Surgery The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Hepatobiliary Pancreatic and Gastrointestinal Malignant Tumors Precise Treatment of Fujian Province the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Fujian Provincial Key Laboratory of Precision Medicine for Cancer The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Department of Hepatopancreatobiliary Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Di","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Institute of Abdominal Surgery The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Hepatobiliary Pancreatic and Gastrointestinal Malignant Tumors Precise Treatment of Fujian Province the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Fujian Provincial Key Laboratory of Precision Medicine for Cancer The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Department of Hepatopancreatobiliary Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, the First Affiliated Hospital Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan\u2010Yuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery The Zhangzhou Affiliated Hospital of Fujian Medical University  Zhangzhou 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Fuzhou China"},{"name":"Department of Hepatopancreatobiliary Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi\u2010Jian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Institute of Abdominal Surgery The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Hepatobiliary Pancreatic and Gastrointestinal Malignant Tumors Precise Treatment of Fujian Province the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Fujian Provincial Key Laboratory of Precision Medicine for Cancer The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Department of Hepatopancreatobiliary Surgery National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang\u2010Jia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Biliary\u2010Pancreatic and Vascular Surgery The First Affiliated Hospital of Xiamen University  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan\u2010Geng","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery the First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Institute of Abdominal Surgery The First Affiliated Hospital of Fujian Medical University  Fuzhou China"},{"name":"Clinical Research Center for Hepatobiliary Pancreatic and Gastrointestinal Malignant Tumors Precise Treatment of Fujian Province the First Affiliated Hospital of Fujian Medical University  Fuzhou 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