Yang YH. Transcatheter arterial chemoembolization plus lenvatinib toward precision prognostication for unresectable hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(6): 116250 [DOI: 10.4251/wjgo.v18.i6.116250]
Corresponding Author of This Article
Yu-Han Yang, Assistant Professor, West China Hospital, Sichuan University, No. 17 People’s South Road, Chengdu 6100041, Sichuan Province, China. yyh_1023@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2026; 18(6): 116250 Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.116250
Transcatheter arterial chemoembolization plus lenvatinib toward precision prognostication for unresectable hepatocellular carcinoma
Yu-Han Yang
Yu-Han Yang, West China Hospital, Sichuan University, Chengdu 6100041, Sichuan Province, China
Author contributions: Yang YH was responsible for conceptualization, writing the original draft, and reviewing and editing the manuscript, read and approved the final manuscript and agree to be accountable for all aspects of the work.
AI contribution statement: No use of AI tools for the manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Yu-Han Yang, Assistant Professor, West China Hospital, Sichuan University, No. 17 People’s South Road, Chengdu 6100041, Sichuan Province, China. yyh_1023@163.com
Received: November 6, 2025 Revised: January 2, 2026 Accepted: February 4, 2026 Published online: June 15, 2026 Processing time: 215 Days and 11.5 Hours
Abstract
A recent study presented a timely prognostic model deriving from a meta-analysis of 43 group studies and externally validated with clinical data for predicting overall survival and progression-free survival in patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus lenvatinib. The model integrated nine readily available clinical variables, including number of tumors, microvascular invasion, Eastern Cooperative Oncology Group grade, Child-Pugh stage, triple therapy with programmed death 1 inhibitors, Barcelona Clinic Liver Cancer stage, extrahepatic metastasis, alpha-fetoproteinlevel, and hepatitis B virus (HBV) status, and demonstrated favorable discrimination relative to Barcelona Clinic Liver Cancer staging. This article acknowledges that the underlying evidence base is predominantly observational and derived largely from HBV-endemic regions; therefore, prospective and geographically diverse validation is required before broad clinical implementation. This article acknowledges the study’s strengths concerning large evidence synthesis, external validation, and clinical applicability while offering constructive critique on methodology, potential biases, biologic interpretation, and steps to maximize translational impact. More priorities could be proposed for refining and prospectively validating the model, integrating molecular and imaging biomarkers, addressing heterogeneity from HBV-endemic populations, and designing interventional studies to test model-guided therapy. Future work should test the model in prospective, multiethnic cohorts, examine interactions with etiologic subtypes (HBV/hepatitis C virus/non-alcoholic steatohepatitis), and integrate temporally aware analyses and biomarker/imaging data to optimize individualized treatment selection. These measures would strengthen the model’s role as a decision-support tool and accelerate evidence-based personalized care in advanced unresectable hepatocellular carcinoma.
Core Tip: We summarized risk factors including number of tumors, microvascular invasion, Eastern Cooperative Oncology Group performance status, and Child-Pugh stage, and protective factor (triple therapy) for unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus lenvatinib, constructed and validated prognostic models. In the validation set, area under the curve values of overall survival and progression-free survival, calibration curves, confirmed their good performance, providing guidance for clinical practice.
