Postoperative adjuvant transcatheter arterial chemoembolization improves the prognosis of patients with huge hepatocellular carcinoma,Hepatobiliary & Pancreatic Diseases International

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Postoperative adjuvant transcatheter arterial chemoembolization improves the prognosis of patients with huge hepatocellular carcinoma
Hepatobiliary & Pancreatic Diseases International ( IF 3.6 ) Pub Date : 2021-01-05 , DOI: 10.1016/j.hbpd.2020.12.018
Han Wang ₁ , Hua Yu ₁ , You-Wen Qian ₁ , Zhen-Ying Cao ₁ , Meng-Chao Wu ₂ , Wen-Ming Cong ₁

Affiliation

Background

Surgical resection of huge hepatocellular carcinoma (HCC, ≥ 10 cm) is potentially curative. More adjuvant treatments are needed to reduce relapses in these patients. We evaluated the influence of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) on the prognosis of huge HCC.

Methods

Data from consecutive patients who underwent curative resection for huge HCC in our center were retrospectively collected. Recurrence-free survival (RFS) and overall survival (OS) were compared between patients who did and did not undergo PA-TACE. Propensity score matching (PSM) was used.

Results

Among the 255 enrolled patients, 93 underwent PA-TACE. The clinical outcomes were significantly better in the PA-TACE group than those in the non PA-TACE group (5-year RFS rate: 33.5% vs. 18.0%; 5-year OS rate: 47.0% vs. 28.0%, all P < 0.001). After PSM, similar results were obtained (5-year RFS rate: 28.8% vs. 17.6%, P < 0.001; 5-year OS rate: 42.5% vs. 25.0%, P = 0.004). PA-TACE decreased the possibility of early recurrence (< 2 years, crude cohort: P < 0.001, PSM cohort: P < 0.001) but not late recurrence (≥ 2 years, crude cohort: P = 0.692, PSM cohort: P = 0.325). Multivariable Cox regression analysis suggested that PA-TACE was an independent protective factor prolonging early RFS, RFS and OS.

Conclusions

PA-TACE is a safe intervention for huge HCC patients after liver resection and improves outcomes.

中文翻译：

术后辅助经导管动脉化疗栓塞改善巨大肝细胞癌患者的预后

背景

巨大肝细胞癌（HCC，≥ 10 cm）的手术切除具有潜在治愈性。需要更多的辅助治疗来减少这些患者的复发。我们评估了术后辅助经导管动脉化疗栓塞术 (PA-TACE) 对巨大 HCC 预后的影响。

方法

回顾性收集了在我们中心接受巨大 HCC 根治性切除术的连续患者的数据。比较了接受和未接受 PA-TACE 的患者的无复发生存期 (RFS) 和总生存期 (OS)。使用倾向评分匹配（PSM）。

结果

在 255 名入组患者中，93 名接受了 PA-TACE。PA-TACE 组的临床结果明显优于非 PA-TACE 组（5 年 RFS 率：33.5% 对 18.0%；5 年 OS 率：47.0% 对 28.0%，所有P < 0.001)。在 PSM 之后，获得了类似的结果（5 年 RFS 率：28.8% 对 17.6%，P < 0.001；5 年 OS 率：42.5% 对 25.0%，P = 0.004）。PA-TACE 降低了早期复发的可能性（< 2 年，粗略队列：P < 0.001，PSM 队列：P < 0.001）但不降低晚期复发（≥ 2 年，粗略队列：P = 0.692，PSM 队列：P = 0.325)。多变量 Cox 回归分析表明 PA-TACE 是延长早期 RFS、RFS 和 OS 的独立保护因素。