Abstract
A recent study by Lu et al examined the potential benefits of postoperative combined therapy (PCT) using anti-programmed cell death protein-1/PD-ligand-1 and anti-vascular endothelial growth factor agents for patients with hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC). At the same time, the findings offer important insights; however, several methodological and statistical limitations should be noted. These limitations include selection bias from the study's retrospective design, variability in treatment regimens, a small sample size, and inadequate monitoring of hepatitis B virus (HBV) reactivation. The study's conclusions about PCT efficacy warrant cautious interpretation due to unresolved biases. Prospective trials with biomarker stratification are critical to confirm these preliminary findings. These findings underscore the need for prospective, biomarker-driven trials to validate the efficacy of PCT. Future research should prioritize standardized regimens, HBV reactivation monitoring, and global collaborations to optimize therapeutic strategies for HBV-HCC.