Abstract
Biomarkers for predicting survival benefit of postoperative adjuvant anti-PD-1 therapy (PA-PD-1) in hepatocellular carcinoma (HCC) are scare and lack of clinical evidence currently. This study aimed to identify the value of preoperative MRI features for predicting response to PA-PD-1 in HCC. Between 2020 and 2023, 58 patients with PA-PD-1 and 110 without PA-PD-1 were retrospectively included after propensity-score matching. Patients with PA-PD-1 had significantly longer recurrence-free survival (RFS) than those without PA-PD-1 (29.50 versus 10.97 months, p = 0.005). Absence of hypointense halos and irregular rim-like hyper enhancement were identified as independent predictors for RFS. Subgroup analysis indicated that patients with absence of hypointense halos and irregular rim-like hyper enhancement achieved significantly longer RFS after PA-PD-1 compared with those without PA-PD-1. In conclusion, preoperative MRI features of absence of hypointense halos and irregular rim-like hyper enhancement were significantly associated with recurrence and potential predictors for response to PA-PD-1 in HCC.