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Background <p>The prognostic value of curative therapies—including liver transplantation, hepatectomy, and local ablation—in patients with advanced hepatocellular carcinoma (HCC) following atezolizumab plus bevacizumab treatment remains unclear. This study evaluated the feasibility of curative therapy and compared survival outcomes between patients who did and did not undergo curative interventions following atezolizumab plus bevacizumab, using a propensity score-matched (PSM) analysis.</p> Methods <p>We retrospectively analyzed 318 consecutive patients with advanced HCC who received atezolizumab plus bevacizumab between 2020 and 2024. Overall survival (OS) and progression-free survival (PFS) were defined as the primary and secondary endpoints, respectively. Survival outcomes were estimated using the Kaplan–Meier method and evaluated with multivariate Cox proportional hazards regression, modeling exposure to conversion curative therapy as a time-dependent covariate.</p> Results <p>The objective response rate to atezolizumab plus bevacizumab was 34.6%. Thirty-six patients (11%) subsequently underwent curative therapy, including liver transplantation (<i>n</i> = 8, 2.5%), hepatectomy (<i>n</i> = 11, 3.5%), and local ablation (<i>n</i> = 17, 5.3%). Patients receiving curative therapy demonstrated significantly improved OS (<i>p</i> &lt; 0.001) and PFS (<i>p</i> &lt; 0.001) compared with those who did not, with benefits persisting after PSM analysis. Multivariate Cox regression identified curative therapy as an independent predictor of OS (hazard ratio [HR] 0.398; 95% confidence interval [CI] 0.179–0.885; <i>p</i> = 0.024).</p> Conclusions <p>In selected patients with advanced HCC who achieved disease control after atezolizumab–bevacizumab, conversion curative therapy was associated with favorable survival outcomes.</p>

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Survival outcomes of conversion curative therapy following atezolizumab–bevacizumab in advanced hepatocellular carcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月13日

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  • Ying-Hsin Chen,
  • Wei-Feng Li,
  • Yen-Hao Chen,
  • Ming-Chao Tsai,
  • Yuan-Hung Kuo,
  • Jing-Houng Wang,
  • Chien-Hung Chen,
  • Sheng-Nan Lu,
  • Chih-Chi Wang,
  • Chao-Hung Hung

摘要

Background

The prognostic value of curative therapies—including liver transplantation, hepatectomy, and local ablation—in patients with advanced hepatocellular carcinoma (HCC) following atezolizumab plus bevacizumab treatment remains unclear. This study evaluated the feasibility of curative therapy and compared survival outcomes between patients who did and did not undergo curative interventions following atezolizumab plus bevacizumab, using a propensity score-matched (PSM) analysis.

Methods

We retrospectively analyzed 318 consecutive patients with advanced HCC who received atezolizumab plus bevacizumab between 2020 and 2024. Overall survival (OS) and progression-free survival (PFS) were defined as the primary and secondary endpoints, respectively. Survival outcomes were estimated using the Kaplan–Meier method and evaluated with multivariate Cox proportional hazards regression, modeling exposure to conversion curative therapy as a time-dependent covariate.

Results

The objective response rate to atezolizumab plus bevacizumab was 34.6%. Thirty-six patients (11%) subsequently underwent curative therapy, including liver transplantation (n = 8, 2.5%), hepatectomy (n = 11, 3.5%), and local ablation (n = 17, 5.3%). Patients receiving curative therapy demonstrated significantly improved OS (p < 0.001) and PFS (p < 0.001) compared with those who did not, with benefits persisting after PSM analysis. Multivariate Cox regression identified curative therapy as an independent predictor of OS (hazard ratio [HR] 0.398; 95% confidence interval [CI] 0.179–0.885; p = 0.024).

Conclusions

In selected patients with advanced HCC who achieved disease control after atezolizumab–bevacizumab, conversion curative therapy was associated with favorable survival outcomes.