{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:48:12Z","timestamp":1782712092967,"version":"3.54.5"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to compare the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) and adjuvant lenvatinib plus tislelizumab (PA-LT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0\u2013B hepatocellular carcinoma (HCC) who were at high risk of recurrence following radical liver resection (LR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study retrospectively evaluated HCC patients who underwent LR at two clinical centers between January 1, 2019 and January 31, 2025. Recurrence-free survival (RFS) and overall survival (OS) were compared across three groups: LR alone, PA-TACE, and PA-LT. Propensity score matching (PSM) was conducted to reduce intergroup heterogeneity and to enhance the robustness of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 614 patients with HCC at high risk of recurrence after radical resection were included in this study. After PSM, 148, 223, and 75 patients were retained in the LR, PA-TACE, and PA-LT groups, respectively. Compared with the LR group, both the PA-TACE and PA-LT groups were associated with significant improvements in RFS and OS (all p &amp;lt; 0.001), and no severe adverse events were observed in either group. However, no significant differences in RFS or OS were observed between the PA-TACE and PA-LT groups (median RFS: 44.00 months (95% CI, 40.91\u201347.09) vs. 40.50 months (95% CI, 34.90\u201346.10), p = 0.086; median OS: 69.00 months (95% CI, 66.44\u201371.56) vs. 65.00 months (95% CI, 60.93\u201369.07), p = 0.572). Multivariable Cox regression analysis demonstrated that both PA-TACE and PA-LT were independently associated with improved RFS and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both PA-TACE and PA-LT were associated with improved RFS and OS in hepatocellular carcinoma patients at high risk of recurrence after radical resection, with acceptable safety profiles. However, no significant differences were observed between the two adjuvant treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1778330","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:40:43Z","timestamp":1782711643000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy of postoperative adjuvant transcatheter arterial chemoembolization versus lenvatinib plus tislelizumab in patients with BCLC stage 0 -B hepatocellular carcinoma after radical resection"],"prefix":"10.3389","volume":"17","author":[{"given":"Xu","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Yongchuan Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yupei","family":"Ao","sequence":"additional","affiliation":[{"name":"Health Screening Centre, Chongqing Western Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Yongchuan Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengjia","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Yongchuan Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The Affiliated Yongchuan Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.6987","article-title":"Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"8","author":"Kocarnik","year":"2022","journal-title":"JAMA Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16081582","article-title":"Hepatocellular carcinoma: Current drug therapeutic status, advances and challenges","volume":"16","author":"Zheng","year":"2024","journal-title":"Cancers (Basel)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0022","article-title":"Hepatobiliary cancers, version 2.2021, NCCN clinical practice guidelines in oncology","volume":"19","author":"Benson","year":"2021","journal-title":"J Natl Compr Canc Netw"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3350\/kjhep.2009.15.3.391","article-title":"EASL clinical practice guidelines on the management of hepatocellular carcinoma","volume":"82","year":"2025","journal-title":"J Hepatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"581","DOI":"10.12290\/xhyxzz.2024-0304","article-title":"Guidelines for the diagnosis and treatment of primary liver cancer (2024 edition)","volume":"32","year":"2024","journal-title":"Chin J Hepatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1098958","article-title":"Adjuvant therapy following curative treatments for hepatocellular carcinoma: current dilemmas and prospects","volume":"13","author":"Guo","year":"2023","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2024.02.115","article-title":"Role of microvascular invasion in early recurrence of hepatocellular carcinoma after liver resection: A literature review","volume":"47","author":"Zhang","year":"2024","journal-title":"Asian J Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000003534","article-title":"Prognostic impact and predictive model for early non-curative recurrence after liver resection for hepatocellular carcinoma: a retrospective cohort study","volume":"112","author":"Shibamoto","year":"2026","journal-title":"Int J Surg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-021-10174-x","article-title":"Actual long-term survival in hepatocellular carcinoma patients with microvascular invasion: a multicenter study from China","volume":"15","author":"Chen","year":"2021","journal-title":"Hepatol Int"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-12495-z","article-title":"Hepatectomy is beneficial in select patients with multiple hepatocellular carcinomas","volume":"29","author":"Orimo","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"193","DOI":"10.4174\/astr.2022.102.4.193","article-title":"Impact of tumor size on hepatectomy outcomes in hepatocellular carcinoma: a nationwide propensity score matching analysis","volume":"102","author":"Hong","year":"2022","journal-title":"Ann Surg Treat Res"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000000805","article-title":"Effect of transarterial chemoembolization as postoperative adjuvant therapy for intermediate-stage hepatocellular carcinoma with microvascular invasion: a multicenter cohort study","volume":"110","author":"Xiang","year":"2024","journal-title":"Int J Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.7150\/jca.87435","article-title":"Survival effects of postoperative adjuvant TACE in early-HCC patients with microvascular invasion: A multicenter propensity score matching","volume":"15","author":"Qian","year":"2024","journal-title":"J Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000001233","article-title":"Adjuvant transarterial chemoembolization for hepatocellular carcinoma following curative resection: A randomized, open-label, phase 3 trial","volume":"82","author":"Ma","year":"2025","journal-title":"Hepatology"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1323581","article-title":"The current status and future of PD-L1 in liver cancer","volume":"14","author":"Hao","year":"2023","journal-title":"Front Immunol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1159\/000542954","article-title":"Treatment duration of adjuvant immune checkpoint inhibitors in hepatocellular carcinoma patients at high risk of recurrence after resection: A prospective, multicentric cohort study","volume":"14","author":"Su","year":"2025","journal-title":"Liver Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1593153","article-title":"The efficacy and safety of tislelizumab with or without tyrosine kinase inhibitor as adjuvant therapy in hepatocellular carcinoma with high-risk of recurrence after curative resection","volume":"16","author":"Peng","year":"2025","journal-title":"Front Immunol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s12072-019-09929-4","article-title":"The efficacy and safety of lenvatinib for advanced hepatocellular carcinoma in a real-world setting","volume":"13","author":"Obi","year":"2019","journal-title":"Hepatol Int"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01286-z","article-title":"Tislelizumab: first approval","volume":"80","author":"Lee","year":"2020","journal-title":"Drugs"},{"key":"B20","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12916-024-03356-5","article-title":"Efficacy and safety of tislelizumab plus lenvatinib as first-line treatment in patients with unresectable hepatocellular carcinoma: a multicenter, single-arm, phase 2 trial","volume":"22","author":"Xu","year":"2024","journal-title":"BMC Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1038\/s41467-025-68108-2","article-title":"Perioperative tislelizumab plus lenvatinib treatment for resectable hepatocellular carcinoma at high risk of recurrence: single-arm phase II trial","volume":"17","author":"Chen","year":"2026","journal-title":"Nat Commun"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1652717","article-title":"Efficacy of tislelizumab plus lenvatinib in hepatocellular carcinoma after curative hepatectomy: a real-world study","volume":"16","author":"Chen","year":"2025","journal-title":"Front Immunol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ctrv.2018.11.002","article-title":"Updated use of TACE for hepatocellular carcinoma treatment: How and when to use it based on clinical evidence","volume":"72","author":"Raoul","year":"2019","journal-title":"Cancer Treat Rev"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.adengl.2019.05.021","article-title":"Using the common terminology criteria for adverse events (CTCAE - version 5.0) to evaluate the severity of adverse events of anticancer therapies","volume":"112","author":"Freites-Martinez","year":"2021","journal-title":"Actas Dermosifiliogr (Engl Ed)"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2147\/jhc.s556979","article-title":"Immunotherapy-based strategies versus transcatheter arterial chemoembolization and the impact of treatment duration in hepatocellular carcinoma with microvascular invasion: a retrospective multicenter cohort study","volume":"12","author":"Chen","year":"2025","journal-title":"J Hepatocell Carcinoma"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.11.016","article-title":"The chances of hepatic resection curing hepatocellular carcinoma","volume":"72","author":"Cucchetti","year":"2020","journal-title":"J Hepatol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2147\/jhc.s504016","article-title":"Combined TACE with targeted and immunotherapy versus TACE alone improves DFS in HCC with MVI: a multicenter propensity score matching study","volume":"12","author":"Chen","year":"2025","journal-title":"J Hepatocell Carcinoma"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyaf139","article-title":"Adjuvant transarterial chemoembolization plus lenvatinib for patients with HCC with MVI after resection: a multicenter retrospective study","volume":"30","author":"Hou","year":"2025","journal-title":"Oncologist"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.2147\/jhc.s510814","article-title":"Adjuvant hepatic arterial infusion chemotherapy versus transarterial chemoembolization for preventing early recurrence after surgical resection in hepatocellular carcinoma","volume":"12","author":"Xia","year":"2025","journal-title":"J Hepatocell Carcinoma"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.ccr-17-2899","article-title":"Adjuvant transarterial chemoembolization for HBV-related hepatocellular carcinoma after resection: a randomized controlled study","volume":"24","author":"Wang","year":"2018","journal-title":"Clin Cancer Res"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)01796-8","article-title":"Atezolizumab plus bevacizumab versus active surveillance in patients with resected or ablated high-risk hepatocellular carcinoma (IMbrave050): a randomised, open-label, multicentre, phase 3 trial","volume":"402","author":"Qin","year":"2023","journal-title":"Lancet"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1202039","article-title":"Postoperative adjuvant tyrosine kinase inhibitors combined with anti-PD-1 antibodies improves surgical outcomes for hepatocellular carcinoma with high-risk recurrent factors","volume":"14","author":"Li","year":"2023","journal-title":"Front Immunol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2024.05.001","article-title":"Postoperative lenvatinib + PD-1 blockade reduces early tumor recurrence in hepatocellular carcinoma with microvascular invasion (Barcelona Clinic Liver Cancer stage 0 or A): a propensity score matching analysis","volume":"28","author":"Danzeng","year":"2024","journal-title":"J Gastrointest Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/s12885-023-10802-9","article-title":"Efficacy of adjuvant TACE on the prognosis of patients with HCC after hepatectomy: a multicenter propensity score matching from China","volume":"23","author":"Wu","year":"2023","journal-title":"BMC Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.09.025","article-title":"Mechanism of action, pharmacokinetics, efficacy, and safety of transarterial therapies using ethiodized oil: preclinical review in liver cancer models","volume":"29","author":"Gaba","year":"2018","journal-title":"J Vasc Interv Radiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-10326-7","article-title":"Ethiodized oil as an imaging biomarker after conventional transarterial chemoembolization","volume":"34","author":"Mendiratta-Lala","year":"2024","journal-title":"Eur Radiol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/ph17081057","article-title":"Hypoxia as a target for combination with transarterial chemoembolization in hepatocellular carcinoma","volume":"17","author":"Wang","year":"2024","journal-title":"Pharm (Basel)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"802","DOI":"10.3892\/ol.2014.2512","article-title":"Efficacy of transarterial chemoembolization combined with sorafenib on microvascular invasion in hepatocellular carcinoma patients after radical resection","volume":"37","author":"Zhang Peng","year":"2025","journal-title":"J Hepatopancreatobiliary Surg"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7659\/j.issn.1005-6947.260017","article-title":"Expert consensus on postoperative adjuvant therapy for hepatocellular carcinoma (2026 edition)","volume":"35","year":"2026","journal-title":"Chin J Gen Surg"},{"key":"B40","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s13045-024-01549-2","article-title":"Immunosuppressive tumor microenvironment and immunotherapy of hepatocellular carcinoma: current status and prospectives","volume":"17","author":"Shen","year":"2024","journal-title":"J Hematol Oncol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25115584","article-title":"The role of metabolic reprogramming in the tumor immune microenvironment: mechanisms and opportunities for immunotherapy in hepatocellular carcinoma","volume":"25","author":"Hu","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1070961","article-title":"PD-1\/PD-L1 checkpoint inhibitors in advanced hepatocellular carcinoma immunotherapy","volume":"13","author":"Li","year":"2022","journal-title":"Front Immunol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1038\/s41392-024-02075-w","article-title":"Hepatocellular carcinoma: signaling pathways and therapeutic advances","volume":"10","author":"Zheng","year":"2025","journal-title":"Signal Transduct Target Ther"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1035323","article-title":"Manipulation of the crosstalk between tumor angiogenesis and immunosuppression in the tumor microenvironment: insight into the combination therapy of anti-angiogenesis and immune checkpoint blockade","volume":"13","author":"Zheng","year":"2022","journal-title":"Front Immunol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1487610","article-title":"Leveraging the synergy between anti-angiogenic therapy and immune checkpoint inhibitors to treat digestive system cancers","volume":"15","author":"Xu","year":"2024","journal-title":"Front Immunol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1186\/s12885-019-5989-2","article-title":"Liver function changes after transarterial chemoembolization in US hepatocellular carcinoma patients: the LiverT study","volume":"19","author":"Miksad","year":"2019","journal-title":"BMC Cancer"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1778330\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:41:26Z","timestamp":1782711686000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1778330\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":46,"alternative-id":["10.3389\/fimmu.2026.1778330"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1778330","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"article-number":"1778330"}}