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Related Experiment Video

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Conversion Resection or Direct Resection for Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicentre

Ying Zhou1, Haiqing Wang2, Jiayi Wu3

  • 1Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.

Liver Cancer
|December 19, 2025
PubMed
Summary

Conversion therapy before surgery significantly improves outcomes for intermediate-stage hepatocellular carcinoma (HCC) patients. This approach enhances pathological responses and long-term survival, offering new hope for HCC treatment.

Keywords:
Conversion resectionHepatocellular carcinomaPathologyPrognosis

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Area of Science:

  • Hepatobiliary Surgery
  • Oncology
  • Gastroenterology

Background:

  • Hepatocellular carcinoma (HCC) often presents at an intermediate stage with poor prognosis.
  • Current treatments for intermediate-stage HCC have limitations in improving overall survival.

Purpose of the Study:

  • To evaluate the efficacy of conversion therapy followed by resection in intermediate-stage HCC.
  • To compare conversion therapy outcomes with direct resection and comprehensive therapy alone.
  • To analyze pathological responses and long-term survival in HCC patients.

Main Methods:

  • A multicentre study enrolled 248 intermediate-stage HCC patients.
  • Patients were divided into conversion resection, direct resection, and comprehensive therapy groups.
  • Propensity score matching was used to balance baseline characteristics and evaluate pathological responses.

Main Results:

  • The conversion resection group showed significantly improved pathological complete response rates (23.2%) and major pathological response rates (51.8%).
  • Lower microvascular invasion (17.9%) and better tumor differentiation were observed in the conversion resection group.
  • Conversion resection led to improved recurrence-free survival (not reached vs. 12.3 months) and 3-year overall survival (94.7%).

Conclusions:

  • Preoperative conversion therapy significantly enhances pathological responses in intermediate-stage HCC.
  • Conversion therapy is an independent prognostic factor, improving both recurrence-free and overall survival.
  • This approach offers a promising strategy for improving outcomes in intermediate-stage HCC.