手术后辅助治疗在肝细胞癌（HCC）的临床作用仍未明确。本研究的目的是探索术后辅助抗程序性细胞死亡1抗体（PA-PD-1）对于高复发风险HCC患者术后预后的临床价值。我们前瞻性地收集了2019年1月至2021年3月期间在我中心接受肝切除治疗并存在高复发风险的HCC患者的数据。通过倾向性评分匹配（PSM）来平衡肝切除术后接受PA-PD-1治疗（PA-PD-1组）或不接受（非PD-1组）的HCC患者的基线差异。在这两组之间比较总生存期（OS）和无复发生存期（RFS）。独立预后风险因素的OS和RFS通过Cox回归分析得到确认，并进行亚组分析。共匹配了47对接受或不接受PD-1治疗的患者。在PSM后，PA-PD-1组1年和2年的RFS分别为58.4％和44.1％，而非-PD-1组分别为34.0％和21.3％（p = 0.008）。PA-PD-1组的1年和2年OS为91.2％和91.2％，而非PD-1组分别为85.1％和61.7％（p = 0.024）。多变量分析表明，PA-PD-1是与RFS和OS相关的独立保护性预测因素。通过亚组分析，我们得出结论，对于存在门静脉肿瘤栓或肿瘤大小≥5厘米的HCC患者，PA-PD-1治疗能够显著提高其RFS和OS。在这个前瞻性观察性研究中，辅助抗PD-1抗体能够有效提高肝切除术后存在高复发风险HCC患者的生存结果。这一发现应该通过正在进行的第3期随机对照试验的结果进行确认。©2023亚太肝脏研究协会。

The clinical role of postoperative adjuvant therapy in hepatocellular carcinoma (HCC) is still unclear. The purpose of our study was to explore the clinical value of postoperative adjuvant anti-programed cell death 1 antibody (PA-PD-1) on the prognosis of HCC patients with high relapse risks after surgery.Data of consecutive HCC patients with high recurrence risks treated with liver resection at our center during January 2019 and March 2021 were prospectively collected. Baseline differences were balanced between HCC patients with (PA-PD-1 group) or without PA-PD-1 (non-PD-1 group) after hepatectomy by propensity-score matching (PSM). Between these two groups, we compared overall survival (OS) and recurrence-free survival (RFS). Independent prognostic risk factors for OS and RFS were confirmed by Cox regression analysis, and subgroup analysis was also performed.47 pairs of patients with or without PD-1 treatment after hepatectomy were matched. After PSM, the 1-year and 2-year RFS was 58.4% and 44.1% in the PA-PD-1 group, and 34.0% and 21.3% in the non-PD-1 group (p = 0.008). The OS at 1 year and 2 years was 91.2% and 91.2% in the PA-PD-1 group, compared with 85.1% and 61.7% in the non-PD-1 group (p = 0.024). Multivariable analyses demonstrated that PA-PD-1 was an independent protective predictor associated with RFS and OS. Through subgroup analysis, we concluded that HCC patients with portal venous tumor thrombus (PVTT) or tumor size ≥ 5 cm significantly benefited from PA-PD-1 therapy in RFS and OS.Adjuvant anti-PD-1 antibody can effectively improve the survival outcomes of HCC patients with high relapse risks after hepatectomy in this prospective observational study. This finding should be confirmed by results of the ongoing phase 3 randomized controlled trials.© 2023. Asian Pacific Association for the Study of the Liver.