{
  "abstract": "Background: Hepatocellular carcinoma (HCC) carries a high recurrence risk after curative resection, yet effective adjuvant strategies remain lacking. Although donafenib plus anti-PD-1 monoclonal antibodies has shown efficacy in advanced HCC, the effectiveness in patients at high recurrence risk after curative resection remains unclear.\n\nMethods: This retrospective cohort study included 143 patients with high-risk HCC after curative resection between June 2019 and April 2024. Patients received adjuvant donafenib plus sintilimab (n=76) or active surveillance (n=67). IPTW, stabilized IPTW (sIPTW), and propensity score matching (PSM) were applied to reduce baseline imbalance. The primary endpoint was recurrence-free survival (RFS), with overall survival (OS) and treatment-emergent adverse events (TEAEs) as secondary endpoints. Survival outcomes were assessed using Kaplan–Meier analysis and Cox regression models.\n\nResults: After IPTW adjustment, adjuvant donafenib plus sintilimab was associated with improved RFS compared with surveillance (median RFS, 22.4 vs. 17.4 months; P = 0.036). The 12- and 24-month RFS rates were 78.2% and 44.4% versus 64.4% and 33.2%, respectively. Multivariable Cox analysis confirmed an independent association between adjuvant therapy and reduced recurrence risk (HR, 0.58; 95% CI, 0.35–0.96; P = 0.036), with consistent results in sIPTW and PSM analyses. OS showed a favorable but nonsignificant trend. Subgroup analyses demonstrated a consistent trend toward RFS benefit across most clinically relevant strata. Among treated patients, TEAEs occurred in 72.4%, mainly grade 1–2 events; grade ≥3 events occurred in 7.9%, with no treatment-related deaths.\n\nConclusions: Adjuvant donafenib plus sintilimab was associated with improved RFS in patients with high-risk HCC, with an acceptable safety profile, supporting its potential as a risk-adapted adjuvant strategy that warrants further validation in prospective studies.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Hepato‐Pancreato‐Biliary Surgery, The First Medical Center, Chinese People's Liberation Army (PLA) General Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Chenggang Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Hanchuan Shen"
    },
    {
      "affs": [
        0
      ],
      "name": "Yang Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Tianci Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Chaoxian Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d9qcvxt5n8z15.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1736128",
  "fulltext_url": "https://europepmc.org/articles/PMC13713841",
  "id": "d9qcvxt5n8z15",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1736128/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2721|Hepatocellular Carcinoma Treatment and Prognosis"
    ]
  ],
  "openalex": "W7221765661",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1736128/pdf",
  "pmcid": "PMC13713841",
  "pmid": "42953126",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/d9qcvxt5n8z15.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1736128",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1736128/full"
    },
    {
      "first_seen": "2026-10-31T00:20:41Z",
      "native_id": "MED:42953126",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953126"
    },
    {
      "first_seen": "2026-11-01T12:21:26Z",
      "native_id": "PMC13713841",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1736128"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Adjuvant donafenib plus sintilimab therapy for hepatocellular carcinoma at high risk of recurrence after resection: a retrospective cohort study",
  "title_text": "Adjuvant donafenib plus sintilimab therapy for hepatocellular carcinoma at high risk of recurrence after resection: a retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:26Z",
  "url": "https://research.draconitic.com/paper/d9qcvxt5n8z15",
  "venue": "Frontiers in Immunology",
  "versions": []
}