{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:04:27Z","timestamp":1780052667682,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Management of hepatocellular carcinoma (HCC) with main portal vein (MPV) invasion is challenging. We aimed to explore the efficacy and safety of systemic lenvatinib therapy combined with potent locoregional transarterial therapy (e.g., chemoembolisation plus infusion chemotherapy) for the treatment of HCC with MPV invasion. Methods: A direct comparison of different therapeutic regimens through a retrospective matched case\u2014control study was conducted to evaluate the survival benefits of lenvatinib monotherapy versus lenvatinib combined with transarterial chemoembolisation (Len-TACE) versus Len-TACE plus hepatic arterial infusion chemotherapy (Len-TACE-HAIC) with oxaliplatin, fluorouracil, and leucovorin. Between January 2022 and December 2024, consecutive patients with HCC and MPV invasion who received lenvatinib, Len-TACE, or Len-TACE-HAIC from multiple centres in South China were enrolled for this analysis. Overall survival (OS), progression-free survival (PFS), and the objective response rate (ORR) were compared across the treatment groups. Adverse events (AEs) related to treatment were also recorded. Results: A total of 169 patients were included in the study: 48 patients received lenvatinib as systemic treatment, 56 received Len-TACE for locoregional and systemic therapy, and 65 received Len-TACE-HAIC for intensified locoregional and systemic treatment. Patients in the Len-TACE-HAIC group achieved a significantly greater ORR (53.8% vs. 28.6% vs. 6.3%, p &lt; 0.001) than those in the Len-TACE group and the Len group did. Consistently, Len-TACE-HAIC resulted in markedly improved PFS (median, 7.0 vs. 5.0 vs. 2.0 months; p &lt; 0.001) and OS (median, 15.0 vs. 10.0 vs. 7.0 months; p &lt; 0.001). The incidence of grade 3-4 AEs was comparable across the three treatment groups. Conclusions: The results demonstrated that lenvatinib combined with potent locoregional therapy, i.e., the Len-TACE-HAIC regimen, provided superior survival benefits with an acceptable safety profile in patients with HCC and MPV invasion.<\/jats:p>","DOI":"10.3390\/cancers18111776","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:06:56Z","timestamp":1780049216000},"page":"1776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Lenvatinib Therapy Combined with Locoregional Chemoembolisation and Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Main Portal Vein Invasion: A Multicentre Retrospective Case\u2014Control Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-9770","authenticated-orcid":false,"given":"Dedi","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Oncology, Southern University of Science and Technology, Shenzhen 518055, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfei","family":"Miao","sequence":"additional","affiliation":[{"name":"Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510510, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hunan Provincial People\u2019s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5683-5790","authenticated-orcid":false,"given":"Wenzhe","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahang","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1159\/000523997","article-title":"Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)","volume":"11","author":"Sun","year":"2022","journal-title":"Liver Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/S2468-1253(19)30178-5","article-title":"Management of patients with hepatocellular carcinoma and portal vein tumour thrombosis: Comparing east and west","volume":"4","author":"Lu","year":"2019","journal-title":"Lancet Gastroenterol. 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