Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Radiologic partial response poorly predicts pathologic complete response in hepatocellular carcinoma after conversion therapy
Chi Xu, Qiong-Yu Liang, Department of Interventional Treatment, Beijing No. 6 Hospital, Beijing 100007, China
Jia-Peng Sun, Kang Zhou, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Jie Pan, Department of Radiology, Peking Union Medical College Hospital, Beijing 100730, China
Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Co-first authors: Chi Xu and Qiong-Yu Liang.
Co-corresponding authors: Jie Pan and Hai-Tao Zhao.
Author contributions: Xu C, Liang QY, Zhou K, Pan J, and Zhao HT designed the research study; Xu C and Liang QY contributed equally to this article and are the co-first authors of this manuscript; Xu C, Liang QY, and Sun JP performed the research and acquired the data; Zhou K, Pan J, and Zhao HT contributed to the multidisciplinary evaluation of the patients; Liang QY and Sun JP analysed the data; Xu C, Liang QY, Sun JP, and Zhou K wrote and critically revised the manuscript; and all authors have read and approved the final manuscript. Pan J and Zhao HT are co-corresponding authors. They contributed equally as they designed the study, contributed to the multidisciplinary evaluation of patients and supervised the whole research.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board and the Ethics Committee of Peking Union Medical College Hospital (approval No. I-25PJ3360).
Informed consent statement: All study participants, or their legal guardians, provided written informed consent before study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Participants provided informed consent for data sharing. The dataset is available from the corresponding author at markpan6885@163.com.
Corresponding author: Jie Pan, MD, PhD, Department of Radiology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, China. markpan6885@163.com
Received: June 2, 2026
Revised: July 17, 2026
Accepted: August 28, 2026
Published online: September 27, 2026
Processing time: 108 Days and 4.9 Hours
Revised: July 17, 2026
Accepted: August 28, 2026
Published online: September 27, 2026
Processing time: 108 Days and 4.9 Hours
Core Tip
Core Tip: Radiologic response is widely used to assess treatment efficacy in hepatocellular carcinoma after conversion therapy, yet its correlation with pathological response remains uncertain. In this study, radiologic partial response assessed by both Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 and modified RECIST showed poor concordance with pathologic complete response (pCR). Although all patients achieving pCR were classified as responders by modified RECIST, most radiologic responders still had residual viable tumor. These findings underscore the limitations of imaging-based response assessment and support the integration of additional biomarkers to improve preoperative evaluation and treatment planning.