High rate of recurrence impaired the prognosis of hepatocellular carcinoma (HCC) after surgery. We aimed to explore the safety and efficacy of neoadjuvant drug-eluting bead transarterial chemoembolization (D-TACE) and tislelizumab therapy for resectable or borderline resectable HCC. 41 HCC patients received neoadjuvant therapy and surgery were respectively enrolled. The safety and efficacy of the neoadjuvant therapy were assessed. The prognosis was evaluated and compared with that of 41 matched HCC patients who received surgery alone. 36 (87.8%) patients had adverse events (AEs) and only one patient had a grade 3/4 of ALT elevated. All patients performed surgery successfully and no severe postoperative complications occurred. The objective response rate (ORR) was 56.1% and 87.8% based on RECIST 1.1 and mRECIST, respectively. 15 (36.6%) patients had radiological complete tumor necrosis and the disease control rate (DCR) was 100%. The pathological complete response (pCR) and major pathological response (MPR) was 13 (31.7%) and 18 (43.9%), respectively. The incidence of microvascular invasion (MVI) was 4.9% in neoadjuvant therapy patients, compared with 64.9% before propensity score matching (PSM) and 60.9% after PSM for surgery alone patients. Neoadjuvant therapy patients had a significant better prognosis than surgery alone patients (recurrence-free survival p = 0.041, overall survival p = 0.006). Our preliminary results suggest the neoadjuvant D-TACE and tislelizumab therapy is safe and benefit to the pathological results and prognosis for patients with resectable or borderline resectable HCC.

To evaluate the secretory function of adrenal incidentaloma, this study explored the usefulness of a contrast-enhanced computed tomography (CECT)-based radiomics model for distinguishing aldosterone-producing adenoma (APA) from non-functioning adrenal adenoma (NAA). Overall, 68 APA and 60 NAA patients were randomly assigned (8:2 ratio) to either a training or a test cohort. In the training cohort, univariate and least absolute shrinkage and selection operator regression analyses were conducted to select the significant features. A logistic regression machine learning (ML) model was then constructed based on the radiomics score and clinical features. Model effectiveness was evaluated according to the receiver operating characteristic, accuracy, sensitivity, specificity, F1 score, calibration plots, and decision curve analysis. In the test cohort, the area under the curve (AUC) of the Radscore model was 0.869 [95% confidence interval (CI), 0.734–1.000], and the accuracy, sensitivity, specificity, and F1 score were 0.731, 1.000, 0.583, and 0.900, respectively. The Clinic–Radscore model had an AUC of 0.994 [95% CI, 0.978–1.000], and the accuracy, sensitivity, specificity, and F1 score values were 0.962, 0.929, 1.000, and 0.931, respectively. In conclusion, the CECT-based radiomics and clinical radiomics ML model exhibited good diagnostic efficacy in differentiating APAs from NAAs; this non-invasive, cost-effective, and efficient method is important for the management of adrenal incidentaloma.

Interventional therapies and systemic chemotherapy are the mainstay of treatment for patients with unresectable hepatocellular carcinoma (HCC). This study aimed to generate preliminary evidence regarding the feasibility and safety of transarterial chemoembolization (TACE) combined with hepatic artery infusion chemotherapy (HAIC), targeted therapy, and immunotherapy in patients with unresectable hepatocellular carcinoma (HCC). This retrospective study analyzed 213 patients with unresectable HCC treated with TACE plus HAIC, targeted therapy, and immunotherapy (THTI) or HAIC plus targeted therapy and immunotherapy (HTI) between July 2019 and August 2023. Propensity score matching (PSM) was used to balance potential confounders between patients in the THTI and HTI groups. Overall survival (OS) was assessed using Kaplan-Meier analysis, and the log-rank test was used for between-group comparisons. Cox proportional hazards regression models were used to identify independent influences on patient OS. A total of 213 patients were treated with THTI (n = 41) or HTI (n = 172). After 1:2 PSM, there were 31 patients in the THTI and 62 patients in the HTI groups. After PSM, OS was significantly better in the THTI than in the HTI groups (34.4 vs. 16.3 months, P = 0.013). The objective response rate (ORR) (38.71% vs. 45.16%, P = 0.554) and disease control rate (DCR) (80.65% vs. 79.03%, P = 0.856) were not statistically significant in the THTI and HTI groups. THTI treatment is an independent predictor of OS. All adverse events (AEs) in the THTI and HTI groups were manageable. Compared with HTI, THTI was associated with improved OS in patients with unresectable HCC, with manageable short-term AEs. Quadruple therapy showed encouraging antitumor activity in this retrospective cohort and should be considered exploratory, further large-scale prospective studies are required.

Introduction: Hepatic arterial infusion chemotherapy (HAIC) has been popular for treating unresectable hepatocellular carcinoma (HCC). However, there are few reports comparing the transradial approach (TRA) and transfemoral approach (TFA) in HAIC. Objective: This study aimed to compare the duration of the hepatic artery catheterization, fluoroscopy time (FT), radiation exposure, safety, and quality of life associated with the procedure in patients undergoing HAIC via TRA and TFA. Methods: This prospective, single-center, randomized, controlled study included 120 patients with unresectable HCC undergoing HAIC procedures. Patients were randomly assigned to group A (n = 60, TRA-HAIC) or group B (n = 60, TFA-HAIC). The hepatic artery catheterization time, FT, entrance surface dose (ESD), dose area product (DAP), procedure-related complications, and quality of life associated with the procedure were assessed between the two groups. Independent-sample t-test and analysis of variance (ANOVA) were used to assess differences. Statistical significance was set at P < 0.05. Results: HAIC procedures were successfully performed in both groups. The hepatic artery catheterization time (19.35 ± 5.84 vs. 18.93 ± 5.62 minutes, P = 0.837), FT (2.35 ± 2.23 vs. 2.25 ± 2.16 minutes, P = 0.901), ESD (259.32 ± 167.46 vs. 250.56 ± 170.58 mGy, P = 0.449), and DAP (125.37 ± 60.65 vs. 120.56 ± 64.33 Gy.cm3, P = 0.566) were comparable between the two groups. The incidence of artery occlusion (10.0% vs. 0%, P < 0.001) in the TRA group was significantly higher than that in the TFA group. TRA was associated with a statistically significant (P < 0.05) improvement in the quality of life. Conclusion: TRA to HAIC was associated with greater improvement in the quality of life associated with the procedure compared with TFA. Both approaches to HAIC had similar efficiency, safety, radiation exposure, and procedure duration.

In this case report, we present the case of a 46-year-old woman with a hepatic neuroendocrine tumor (NET G2)-induced liver metastases. Initially, the left lateral lobectomy of the liver was performed. The post-operative pathological examination revealed NET G2, leading to the post-operative recovery with a general review. Further, the re-examination of liver magnetic resonance imaging (MRI) showed post-operative changes in the tumor of the left lateral lobe, with multiple liver masses and possible metastasis. Thus, the liver interventional therapy and apatinib-based targeted therapy based on the “camrelizumab + apatinib” regimen were performed, respectively. The 20-month follow-up indicated a slightly increased hepatic hilum and retroperitoneal lymph nodes, accompanied by hand-foot syndrome. Eventually, the overall condition continued to relieve, indicating that the combined treatment could substantially improve the NET G2 conditions-associated liver metastasis.