BackgroundPancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies with dismal prognosis for unresectable cases. Systemic chemotherapy shows limited efficacy, while transarterial infusion chemotherapy (HAIC) enables targeted drug delivery, and the combination of anti-angiogenic agents and immune checkpoint inhibitors has demonstrated synergistic effects in solid tumors.MethodsIn this retrospective, single-center propensity score-matched study, 183 unresectable PDAC patients treated between January 2021 and December 2024 were analyzed Propensity score matching (PSM) was performed at a 1:1 ratio, resulting in 45 patients in the HAIC + lenvatinib + tislelizumab group and 45 patients in the intravenous chemotherapy group. The primary endpoints were overall survival (OS) and progression-free survival (PFS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), and safety.ResultsAfter PSM, baseline characteristics were well-balanced.1). The HAIC + lenvatinib + tislelizumab group achieved significantly higher ORR (37.8% vs. 17.8%, P = 0.023) and DCR (88.9% vs. 64.4%, P = 0.004) than the chemotherapy group. Median OS was 13.1 months (95% CI: 11.4–14.7) in the experimental group versus 8.8 months (95% CI: 7.1–10.9) in the control group (P<0.001). Median PFS was 6.0 months (95% CI: 5.0–6.9) versus 3.7 months (95% CI: 1.9–4.0), respectively (P<0.001). The most common grade ≥3 adverse events were hypertension (15.6% vs. 2.2%, P = 0.012) in the HAIC + lenvatinib + tislelizumab group and neutropenia (24.4% vs. 6.7%, P = 0.008) in the chemotherapy group.ConclusionsHAIC combined with lenvatinib and tislelizumab significantly was associated with significantly prolonged survival and improved tumor response in unresectable PDAC with manageable toxicity, providing a promising therapeutic strategy for this devastating disease.

BackgroundIcaritin, a prenylated flavonoid extracted from Epimedium, induces apoptosis and modulates immunity with proven antitumor activity in hepatocellular carcinoma (HCC). This study aimed to compare survival outcomes of transarterial chemoembolization (TACE) plus Icaritin versus TACE alone in HCC patients with macrovascular invasion (MVI).MethodsThis multicenter retrospective cohort study, conducted from October 2022 to June 2025, included 288 patients with HCC and MVI from five tertiary hospitals. Patients were assigned to either the TACE plus Icaritin group (n = 144) or the TACE monotherapy group (n = 144). Tumor response was evaluated by mRECIST on contrast-enhanced CT/MRI. Overall survival and progression-free survival were estimated using Kaplan Meier curves and compared by log-rank test; prognostic factors were identified via Cox regression.ResultsThe Icaritin–TACE group showed significantly better outcomes, with longer median OS (16.3 vs. 13.3 months; P = 0.020) and PFS (8.5 vs. 7.6 months; P = 0.006) than the TACE monotherapy group. The disease control rate (DCR) was also higher in the Icaritin–TACE group (84.0% vs. 72.2%; P = 0.015). Multivariate Cox regression analysis identified ECOG performance status, alpha-fetoprotein (AFP) levels, number of lesions, and maximum lesion diameter as independent predictors of OS, while lesion count was independently associated with PFS. The overall incidence of any grade adverse events was similar between groups.ConclusionIcaritin combined with TACE improves OS, PFS, and DCR compared to TACE alone in patients with MVI-associated HCC.

OBJECTIVE:To assess the survival benefit of synchronous systemic therapy plus thermal ablation (TA) in oligometastatic colorectal lung metastases (CRLM) and identify independent prognostic factors. BACKGROUND:Optimizing the integration of systemic therapy and TA for potentially curable CRLM remains a significant clinical challenge. METHODS:This study employed a retrospective cohort design, including 326 patients who underwent TA treatment at six tertiary medical centers from March 2014 to October 2022. Patients were categorized into synchronous therapy, upfront ablation, delayed ablation, and no systemic therapy groups based on the timing of systemic therapy relative to TA. Kaplan-Meier analysis and log-rank tests were used to assess survival outcomes. RESULTS:Synchronous systemic therapy yielded the longest median progression-free survival (PFS) (22.0 months) and overall survival (OS) (61.3 months) compared to delayed ablation (13.0 and 49.2 months, respectively) and no systemic therapy (11.9 and 29.3 months, respectively) (all p < 0.05). Synchronous systemic therapy was an independent protective factor for PFS [hazard ratio (HR) = 0.493] and OS (HR = 0.211). Independent risk factors for local tumor progression included tumor size ≥3 cm (HR = 1.75) and peridiaphragmatic location (HR = 1.48). For PFS, independent predictors included tumor numbers (p < 0.001), synchronous metastases (HR = 1.431), and extrapulmonary metastases (p = 0.001). OS was adversely influenced by tumor burden (p < 0.05), extrapulmonary metastases (p < 0.001), and mediastinal lymph node involvement (HR = 1.518). CONCLUSIONS:Synchronous systemic therapy combined with TA significantly enhances PFS and OS in potentially curable oligometastatic CRLM patients.

Digital subtraction angiography (DSA) devices guide procedures across numerous diseases, performed on more than 100,000 patients daily worldwide. However, these procedures expose patients and healthcare providers to radiation, increasing the risk of health issues. Despite many low-dose DSA imaging methods proposed, none have been prospectively clinically validated. In this study, 46,829 patients (over 5 million DSA images) from 70 centers were used to iterate our previously developed generative artificial intelligence system (named GenDSA-V2). A total of 1,068 patients (533 in intervention arm and 535 in control arm), with suspected cerebral aneurysms (n = 435), lung cancer (n = 417) or advanced liver cancer (n = 216), meeting surgical criteria, were enrolled to validate the GenDSA-V2. The primary outcome was radiation dose, while secondary outcomes included efficiency, operation time and intraoperative complications. Group assignments were blinded to patients, surgeons and investigators, while technicians were aware but not involved in data collection or analysis. The GenDSA-V2 group showed substantially reduced radiation exposure, with an air kerma (AK) of 151.3 ± 125.1 mGy compared to 457.4 ± 407.4 mGy in the standard clinical protocols (SCP) group (mean difference = -306.1 mGy, 95% confidence interval (CI) = -342.3 to -269.9, P < 0.001 for superiority) and a dose-area product (DAP) of 4009.7 ± 2767.9 μGy m2 versus 12531.6 ± 9145.9 μGy m2 (mean difference = -8521.9 μGy m2, 95% CI = -9333.1 to -7710.7, P < 0.001 for superiority). Mean operation time was 33.1 ± 10.8 min in the SCP group and 34.8 ± 11.8 min in the GenDSA-V2 group (mean difference = 1.7 min, 95% CI = 0.3 to 3.1, P < 0.001 for noninferiority). Complication rates were similar (SCP = 8.1%, GenDSA-V2 = 7.5%, mean difference = -0.6%, 95% CI = -3.8% to 2.6%, P < 0.001 for noninferiority). The GenDSA system reduces radiation exposure to both physicians and patients by approximately two-thirds during DSA-guided procedures, demonstrating substantial clinical and translational value. Chinese Clinical Trial Registry: ChiCTR2400084789 .

Abstract Objective To investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib and icaritin in the treatment of patients with unresectable hepatocellular carcinoma (uHCC) with poor physical condition, aiming to provide a safer and more effective treatment strategy for patients with advanced uHCC and poor physical status. Materials and methods Clinical data from 49 patients with uHCC and poor physical condition who received treatment between June 2022 and December 2023 were collected. The patients were divided into two groups based on their treatment method: TACE + LEN+Icaritin group ( N = 21) and TACE group ( N = 28). The primary endpoints were the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of the tumor in both groups. The secondary endpoint was the incidence of treatment-related adverse events (AEs) in both groups. Results The ORR and DCR of the TACE + LEN+Icaritin group were significantly higher than those of the TACE group (66.7% vs. 28.6%, P = 0.011; 85.7% vs. 53.6%, P = 0.030). The mPFS of the TACE + LEN+Icaritin group was longer than that of the TACE group (8.6 months vs. 4.1 months, HR = 0.316, 95%CI: 0.166–0.599; P < 0.001). The incidence of hand-foot syndrome (all grades) was higher in the TACE + LEN+Icaritin group compared to the TACE group ( P = 0.004), but there was no significant difference in the incidence of grade 3/4 hand-foot syndrome between the two groups ( P = 0.429). The incidence of fatigue and anorexia (all grades) was lower in the TACE + LEN+Icaritin group compared to the TACE group ( P < 0.05). A total of 66.7% of patients in the TACE + LEN+Icaritin group showed improvement in physical condition after treatment, which was significantly higher than in the TACE group ( P = 0.022). Conclusion TACE combined with lenvatinib and icaritin demonstrates good efficacy and safety in the treatment of patients with uHCC and poor physical condition (ECOG = 2). This combination therapy may be a viable option for improving prognosis and quality of life in patients with uHCC and poor physical condition.

Introduction: We evaluated the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with regorafenib and icaritin in patients with advanced hepatocellular carcinoma (HCC) progressing after first-line lenvatinib therapy, based on retrospective observational data, with the goal of proposing a novel second-line strategy to improve survival outcomes. Materials and Methods: A retrospective analysis included 79 advanced HCC patients treated at Union Hospital between January 2022 and October 2023, all with confirmed progression after first-line lenvatinib. Participants were divided into two groups: HAIC + regorafenib + icaritin (n=38) and regorafenib monotherapy (n=41). Primary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression- free survival (PFS). Secondary endpoints covered changes in blood biomarkers and treatment-related adverse events (AEs). Results: The triple-therapy group demonstrated superior ORR (44.7% vs. 19.5%, P<0.05) and DCR (73.7% vs. 48.8%, P<0.05) compared to monotherapy. Median PFS (6.7 vs. 3.9 months, P<0.05) and median OS (12.4 vs. 9.2 months, P<0.05) were significantly prolonged with combination therapy. Although all-grade abdominal pain, fever, and vomiting were more frequent in the triple-therapy group (P<0.05), the incidence of grade 3/4 AEs did not differ significantly between groups. Notably, all-grade fatigue was less common in the combination group (P<0.05). Conclusion: HAIC combined with regorafenib and icaritin shows enhanced efficacy and manageable toxicity in lenvatinib-refractory advanced HCC, with improved physical tolerance evidenced by reduced fatigue. The observed benefits of this triplet regimen warrant further prospective validation as a potential personalized secondline approach for Barcelona Clinic Liver Cancer stage C (BCLC-C) patients, pending confirmation in randomized controlled trials.

ObjectiveTo evaluate if transarterial chemoembolization (TACE) combined with Icaritin provides additional survival benefits compared to TACE alone in intermediate-to-advanced hepatocellular carcinoma (HCC) across different Child-Pugh classes.BackgroundTACE is a standard locoregional therapy for intermediate-to-advanced HCC, yet monotherapy yields limited long-term survival. Icaritin, an immunomodulator, demonstrates survival benefits in advanced HCC with a favorable safety profile lacking severe hepatotoxicity or bone marrow suppression.MethodsThis multicenter retrospective cohort study included patients with Barcelona Clinic Liver Cancer (BCLC) stage B and C HCC. Propensity score matching (PSM) was utilized to balance baseline covariates between the TACE with Icaritin and TACE alone groups. The primary endpoint was overall survival (OS).ResultsFollowing PSM, 250 patients were evaluated. In the Child-Pugh grade A group, TACE combined with Icaritin was associated with longer median OS than TACE alone (28.8 vs. 15.7 months; HR, 0.42; 95% CI, 0.29-0.62; P<0.001). Median PFS was also longer in the combination group (9.7 vs. 8.1 months; HR, 0.66; 95% CI, 0.49-0.90; P = 0.007). In Child-Pugh subgroup analyses, the treatment effect was most consistent in patients with Child-Pugh grade A liver function. In Child-Pugh grade B patients, OS favored the combination therapy, whereas the PFS result was not statistically definitive. ORR (49.6% vs. 47.2%) and DCR (83.2% vs. 74.4%) were comparable. The combination regimen did not significantly increase grade 3–4 liver function-related adverse events.ConclusionsTACE combined with Icaritin was associated with improved survival outcomes, with the most consistent benefit observed in patients with Child-Pugh grade A liver function. In Child-Pugh grade B patients, the findings should be interpreted cautiously because of the limited subgroup size and insufficient statistical power.

ObjectiveThis study aimed to develop and evaluate the value of a nomogram based on quantitative MR signal intensity to predict response to combined systemic therapy of anti-angiogenesis and immune checkpoint inhibitor (ICI) in hepatocellular carcinoma (HCC) patients.Methods117 HCC patients who underwent the combined systemic treatment at a tertiary hospital between September 2020 and May 2024 were enrolled and divided into a development cohort (n = 82) and a validation cohort (n = 35). The predictive value of the relative signal intensity attenuation index (rSIAI) based on enhanced MR parameters and laboratory parameters on disease control was evaluated using receiver operating characteristic (ROC) curves, with the determination of optimal cut-off values (COVs) accomplished via Youden’s index. Univariate and multivariable analyses were conducted to evaluate the association between COVs and disease control. The validity of the COVs was further confirmed through chi-square testing and calculation of Cramer’s V coefficient (V). A nomogram was constructed based on the multivariable logistic regression model and evaluated for clinical applicability.ResultsrSIAI from arterial to portal phase (rSI_ap) in combination with peripheral T-cell subset (CD4+) achieved the most accurate predictive performance for outcome compared to rSI_ap or CD4+ alone, with an area under the curve (AUC) of the ROC of 0.845 (95% CI, 0.748-0.915). A nomogram based on rSI_ap and CD4+ was constructed. Calibration and decision curve analyses confirmed the clinical relevance and value of the nomogram.ConclusionThe nomogram based on rSI_ap has the potential to be a non-invasive tool for predicting disease control in advanced HCC patients who have received combined anti-angiogenesis and ICI therapies.

To explore the efficacy and safety of RALOX-HAIC (raltitrexed plus oxaliplatin) combined with lenvatinib in the treatment of elderly patients with unresectable hepatocellular carcinoma (uHCC), aiming to provide a safer and more effective therapeutic strategy for this patient population. A retrospective analysis was conducted on the clinical data of 82 elderly patients with uHCC who received treatment in the Department of Interventional Radiology at Wuhan Union Hospital from January 2019 to December 2022. Patients were divided into two groups based on their treatment strategy: HAIC + Lenvatinib group (N = 39) and TACE group (N = 43). The primary endpoints were the objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) in the two groups. The secondary endpoint was the incidence of treatment-related adverse events in both groups. The ORR and DCR after treatment were higher in the HAIC + Lenvatinib group compared to the TACE group (61.5

BACKGROUND:Colorectal cancer (CRC) frequently metastasizes to the lungs, and image-guided thermal ablation (IGTA) has emerged as a promising treatment for oligometastatic colorectal lung metastases (CRLM). However, high-quality multicenter data remain limited, and the prognostic impact of site-specific extrapulmonary metastases is not well defined. AIM:To assess IGTA efficacy in potentially curable oligometastatic CRLM and determine prognostic impacts of extrapulmonary metastatic patterns. METHODS:This multicenter real-world study analyzed 336 CRLM patients treated with IGTA from 2014 to 2022. Inclusion criteria included pathologically or clinically confirmed oligometastatic CRC, tumor diameter < 50 mm, fewer than 5 metastatic lesions, and ≤ 2 organs involved. Kaplan-Meier and Cox regression methods assessed survival outcomes, including local tumor progression-free survival, progression-free survival (PFS), and overall survival (OS). RESULTS:The 3-year cumulative local tumor progression rate was 14.0%. Median PFS and OS were 15.6 and 51 months, respectively, with 3- and 5-year OS rates of 59.5% and 41.0%. Poor survival outcomes were associated with a higher tumor burden (larger size and greater number), carcinoembryonic antigen > 20 ng/mL, carbohydrate antigen 19-9 > 37 U/mL, and extrapulmonary metastases. Patients without extrapulmonary metastasis had 1-, 3-, and 5-year PFS rates of 65.4%, 31.0%, and 27.3%, respectively, which were longer than those of CRLM patients with liver metastasis [hazard ratio (HR) = 1.449, P = 0.019] and abdominal cavity metastasis (HR = 1.864, P = 0.010). The 1-, 3-, and 5-year OS rates for patients without extrapulmonary metastasis were 96.4%, 71.0%, and 53.0%, respectively, which were significantly longer than those for patients with bone metastasis (HR = 4.538, P < 0.001), abdominal cavity metastasis (HR = 4.813, P < 0.001), and pelvic cavity metastasis (HR = 3.105, P < 0.001). CONCLUSION:Metastatic patterns significantly influence PFS and OS, emphasizing the need for careful patient selection. Notably, patients with liver-only extrapulmonary metastasis demonstrate comparatively favorable outcomes, suggesting a distinct biological behavior and better prognosis within this subgroup.

This study aimed to assess the efficacy and safety of transarterial chemoembolization (TACE) in combination with apatinib (TACE-apatinib) for patients with unresectable hepatocellular carcinoma (HCC). This study was a multicenter, randomized, open-label, prospective, phase III trial. Patients with unresectable HCC were randomly assigned in a 1:1 ratio to receive either TACE-apatinib or TACE-alone treatment. Patients in the TACE-apatinib group began with a dosage of 500 mg/day of oral apatinib administered 4 days after the first TACE. The primary endpoint of this study was progression-free survival (PFS). The secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), time to untreatable (unTACEable) progression (TTUP), and safety assessment. From November 1, 2018 to November 18, 2021, a total of 196 patients were randomly assigned to either the TACE-apatinib (n = 86) or TACE-alone (n = 92) group. The median PFS in the TACE-apatinib group was significantly longer than that of in the TACE-alone group (6.1 months vs. 3.4 months, p < 0.0001). The median OS was significantly prolonged in the TACE-apatinib group compared to the TACE-alone group (28.9 months vs. 24.0 months, p = 0.0005). The median TTUP in the TACE-apatinib group was 26.8 months, which was significantly longer than that of 20.1 months in the TACE-alone group (p = 0.0003). A significantly higher ORR and DCR were observed in the TACE-apatinib group compared to the TACE-alone group (ORR: 58.1

Transarterial chemoembolization (TACE) is a standard treatment for unresectable hepatocellular carcinoma (HCC). However, a significant proportion of patients develop conventional TACE (cTACE) refractoriness, which is associated with poor prognosis. The optimal treatment strategy for cTACE-refractory HCC remains controversial. This study aimed to evaluate the efficacy and safety of drug-eluting bead TACE (D-TACE) combined with lenvatinib versus cTACE plus lenvatinib in patients with cTACE-refractory HCC. We conducted a retrospective analysis of 103 patients with cTACE-refractory unresectable HCC treated at our institution between January 2019 and June 2021. Patients were divided into two groups: the D-TACE + lenvatinib group (n = 48) and the cTACE + lenvatinib group (n = 55). The primary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) assessed according to mRECIST criteria. Secondary endpoints included safety profiles and changes in liver function parameters. The D-TACE + lenvatinib group demonstrated significantly better treatment outcomes compared to the cTACE + lenvatinib group. The ORR was 50.0

ABSTRACT Background Radiofrequency ablation (RFA) is a curative treatment for colorectal liver metastases (CLMs) in selected patients. NCCN guidelines recommend RFA for both unresectable and select resectable CLMs when complete ablation with adequate margins is feasible. While RFA can achieve oncologic outcomes comparable to surgery in well‐selected patients, residual tumors are associated with a poorer prognosis. Objectives To identify predictors of residual tumor after percutaneous RFA for CLMs and evaluate their impact on overall survival (OS) and new intrahepatic metastases (NIHM). Methods We prospectively included patients with CLMs who underwent percutaneous RFA from November 2019 to November 2022. Dynamic contrast‐enhanced computed tomography assessed CLMs before and after RFA. Residual tumor was defined as active tumor visible immediately post‐ablation or within 4–8 weeks, within 1 cm of the ablation zone. Data from three centers formed a developmental cohort, validated with patients from a fourth center. Cox regression and Kaplan–Meier analysis assessed local tumor progression‐free survival (LTPFS), NIHM, and OS. Results Among 200 patients (mean age 61 years, 126 men) with 410 tumors, independent predictors of residual tumors included perivascular tumor location (odds ratio [OR] = 6.673), tumor size ≥ 20 mm (OR = 3.925), and minimal ablative margin (OR = 0.599). These factors also predicted LTPFS. NIHM was more frequent in the residual tumor group than in the complete RFA (cRFA) group (p = 0.002). Median OS was 45 months, shorter in the residual tumor group (30 vs. 48 months, p = 0.009). Patients with NIHM who received transarterial chemoembolization combined with hepatic arterial infusion chemotherapy had a median OS of 43 months, compared to 34 months with RFA alone (p = 0.039). Conclusions A non‐perivascular tumor location, tumor size < 20 mm, and a sufficient ablation margin are essential for achieving complete RFA. Residual tumors are associated with increased NIHM and shorter OS.

BACKGROUND:To investigate the prognostic value of RAS mutation status and subtypes in colorectal lung metastases (CRLM) patients undergoing image-guided thermal ablation (IGTA), and to evaluate survival outcomes under different systemic therapy regimens. MATERIALS AND METHODS:In this multicenter retrospective-prospective cohort study, 387 patients with CRLM who received percutaneous IGTA between March 2014 and December 2022 were included. Patients were stratified by RAS genotype (KRAS/NRAS wild-type vs mutant). Survival outcomes including local tumor progression-free survival (LTPFS), progression-free survival (PFS), and overall survival (OS) were analyzed using Cox regression. Subgroup analyses were conducted based on chemotherapy regimens and targeted agents. RESULTS:The 3-year LTP rate was significantly higher in KRAS-mutant patients (25.0%) than wild-type (15.0%). KRAS mutation, lesion diameter ≥20 mm, and elevated CEA were independent risk factors for LTP. Median PFS was 16.0 months; KRAS mutations predicted inferior PFS (13.3% vs 32.8% at 3 years). Median OS was significantly reduced in both KRAS (17.9 vs 56.8 months) and NRAS-mutant patients (22.1 vs 53.8 months). Among KRAS-mutant patients, FOLFOX plus bevacizumab yielded better OS than cetuximab. CONCLUSION:RAS mutations are independent predictors of poor local control and survival after IGTA in CRLM. Evaluate interactions between RAS genotype and commonly used targeted agents in the peri-ablative setting. These integrated, real-world insights support the development of genotype-guided ablation planning and peri-ablative systemic therapy strategies.

OBJECTIVE:This study aimed to report the 10-year experience of implantation, removal, and adjustment of a totally implantable venous access port (TIVAP) under the guidance of digital subtraction angiography (DSA) at a territory medical center. METHODS:The medical records of consecutive patients who underwent implantation, removal, and adjustment of the TIVAP under DSA guidance from January 2014 to March 2024 were retrospectively reviewed. RESULTS:In total, 290 consecutive patients who underwent TIVAP implantation were included, of which, 136 (46.9%) were men and 154 (53.1%) were women, with a mean age of 44.4 ± 16.5 years. The mean radiation dose was 4.9 ± 1.4 mGy. The operation time was 34.1 ± 3.8 min. The technical success rate was 100%. During a median follow-up of 239 days, 9 cases showed complications. No significant differences were found in age, sex, operation time, and radiation dose between the subclavian vein (SCV) and internal jugular vein (IJV) groups, while there were fewer complications in the IJV group (p = 0.039), and 114 consecutive patients who underwent TIVAP removal were included, of which, 49 (43.0%) were men and 65 (57.0%) were women, with a mean age of 44.3 ± 15.4 years. The median radiation dose was 3.8 (1.3-62.3) mGy. The median interval time from implantation to removal was 358.5 (2-3650) days. The operation time was 34.4 ± 6.1 min. The technical success rate was 100%. No significant differences were observed between the SCV and IJV groups. Cases with fracture and dislocation of the catheters were defined as the complicated group, while the others were defined as the uncomplicated group. The operation time (45.7 ± 12.4 vs. 33.7 ± 4.6 min) and radiation dose (45.4 ± 10.8 vs. 4.2 ± 2.2 mGy) between the above two groups were significantly different (both p < 0.05); A total of nine consecutive patients who underwent adjustment of the TIVAP were included, of which three patients had dislocation of the catheter and six patients had kinking of the catheters. They were all successfully adjusted using a pigtail catheter and/or gooseneck snare. The average operation time and radiation dose were 20.8 ± 5.6 min and 3.2 ± 1.3 mGy. CONCLUSION:Implantation, removal, and adjustment of the venous port access under DSA guidance were safe and efficient. For the removal and adjustment of complicated cases, using the pigtail catheter and/or gooseneck snare under DSA guidance was efficient. In addition, the IJV seems to be a safer venous access site with a lower complication rate than the SCV.

This retrospective study evaluated the efficacy and safety of drug-eluting bead transarterial chemoembolization (D-TACE) combined with Donafenib and Tislelizumab versus D-TACE with Sorafenib in 105 patients with recurrent hepatocellular carcinoma (HCC) after surgical resection (January 2019-June 2023). Patients were divided into D-TACE + Donafenib + Tislelizumab (N = 51) and D-TACE + Sorafenib (N = 54) groups. The D-TACE + Donafenib + Tislelizumab group demonstrated significantly higher objective response rate (62.7% vs. 40.7%, P < 0.05) and disease control rate (84.3% vs. 64.8%, P < 0.05), along with prolonged median progression-free survival (8.7 vs. 5.7 months, P < 0.001) and overall survival (19.2 vs. 12.3 months, P < 0.001). While hypothyroidism incidence was higher in the D-TACE + Donafenib + Tislelizumab group (21.6% vs. 7.4%, P = 0.051), the D-TACE + Sorafenib group exhibited increased fatigue (35.2% vs. 11.8%, P = 0.006) and anorexia (35.2% vs. 13.7%, P = 0.013). These findings suggest that D-TACE combined with Donafenib and Tislelizumab offers superior tumor control and survival benefits with a manageable safety profile, representing a promising therapeutic strategy for postoperative recurrent HCC.

Radiofrequency ablation (RFA) is a commonly used interventional method for treating colorectal cancer liver metastases (CLMs), with its efficacy influenced by tumor characteristics and intrahepatic distribution. The presence of incomplete RFA (iRFA) can result in poorer prognosis and may impede the effectiveness of targeted therapies or immunotherapy. Currently, there is a lack of multicenter prospective cohort studies and predictive models for iRFA. This study prospectively included CLM patients from four medical centers who underwent percutaneous RFA to develop and validate a predictive model for iRFA. All patients were followed up, with the occurrence of new intrahepatic metastases (NIHM) and overall survival (OS) assessed using the Kaplan-Meier method. We identified independent predictors of iRFA, including perivascular tumor location (odds ratio [OR] = 3.164), tumor size ≥ 20 mm (OR = 5.639), and minimal ablative margin (OR = 0.607). The area under the receiver operating characteristic curve (AUC) was 0.884 for the developmental cohort and 0.857 for the external validation cohort. Compared to the complete RFA group, patients in the iRFA group had a higher incidence of NIHM and shorter OS. However, broader external validation and the inclusion of more variables for comprehensive analysis and balance are still needed.

Bile duct injury is a serious complication after transcatheter arterial chemoembolization (TACE). If it is not detected early and treated actively, it will not only affect the subsequent tumor-related treatment of hepatocellular carcinoma (HCC) patients, but also may lead to serious consequences such as infection, liver failure and even death. To analyze the risk factors of bile duct injury after TACE in patients with HCC and explore the predictive indicators of bile duct injury after TACE, which is helpful for doctors to detect and intervene early and avoid the occurrence of serious complications. We retrospectively analyzed the clinical data of 847 patients with primary hepatocellular carcinoma who underwent TACE for the first time in our interventional department. Patients were divided into two groups according to whether bile duct injury occurred after TACE: (1) bile duct injury group, N = 55; (2) no bile duct injury group, N = 792. The basic data, intraoperative conditions and the outcome of bile duct injury were analyzed. The chi-square test was used for comparison of enumeration data. The Mann-Whitney U test was used for comparison of measurement data. Risk factor analysis was performed using binary logistic regression analysis. Basic data and intraoperative conditions were compared between the bile duct injury group and the group without bile duct injury: preoperative alkaline phosphatase (ALP) (103.24 ± 32.77U/L vs. 89.17 ± 37.35U/L, P = 0.003); history of hepatobiliary surgery (36.4