Effect of transarterial chemoembolization as postoperative adjuvant therapy for intermediate-stage hepatocellular carcinoma with microvascular invasion: a multicenter cohort study

被引:12
作者
Xiang, Cailing [1 ]
Shen, Xianbo [2 ]
Zeng, Xinxin [2 ]
Zhang, Yuzhong [2 ]
Ma, Zhongzhi [2 ]
Zhang, Guocan [2 ]
Song, Xin [3 ]
Huang, Tao [4 ]
Yang, Juan [1 ]
机构
[1] Hunan Normal Univ, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Dept Gen Surg 2, Changsha 410005, Peoples R China
[2] Hunan Normal Univ Changsha, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Dept Hepatobiliary Surg, Changsha, Peoples R China
[3] Jishou Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Jishou 416000, Hunan Province, Peoples R China
[4] Sun Yat Sen Univ, Dept Minimally Invas Intervent, State Key Lab Oncol South China, Canc Ctr, Guangzhou, Guangdong Provi, Peoples R China
关键词
hepatocellular carcinoma; liver resection; microvascular invasion; propensity score-matching; transarterial chemoembolization; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; CLINICAL-PRACTICE GUIDELINES; SURGICAL RESECTION; CURATIVE RESECTION; LIVER; RECURRENCE; SURVIVAL; MANAGEMENT; PREDICTOR; DIAGNOSIS;
D O I
10.1097/JS9.0000000000000805
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background:Intermediate-stage hepatocellular carcinoma (HCC) with microvascular invasion (MVI) is associated with high recurrence rates and poor survival outcomes after surgery. This study aimed to evaluate the efficacy of postoperative transarterial chemoembolization (TACE) on prognosis of intermediate-stage HCC patients with MVI after curative liver resection (LR).Materials and methods:Patients who had intermediate-stage HCC with MVI and underwent curative LR between January 2013 and December 2019 at three institutions in China were identified for further analysis. Overall survival (OS) and recurrence-free survival (RFS) were compared between patients treated with and without postoperative TACE by propensity score-matching.Results:A total of 246 intermediate-stage HCC patients with MVI were enrolled, 137 entered into the LR group and 109 entered into the LR+TACE group. The 1-year, 3-year, and 5-year RFS rates were 42.0, 27.2, and 17.8% in LR+TACE group, and 31.8, 18.2, and 8.7% in LR group. The 1-year, 3-year, and 5-year OS rates were 81.7, 47.2, and 26.1% in the LR+TACE group, and 67.3, 35.6, and 18.5% in the LR group. Compared with LR alone, LR+TACE was associated with significantly better RFS [hazard ratio (HR), 1.443; 95% CI: 1.089-1.914; P=0.009] and OS (HR, 1.438; 95% CI: 1.049-1.972; P=0.023). No difference was observed with RFS and OS in single TACE and multiple TACE in the matched cohort.Conclusion:Postoperative adjuvant TACE could be beneficial for intermediate-stage HCC patients with MVI.
引用
收藏
页码:315 / 323
页数:9
相关论文
共 45 条
[1]  
Bai XL, 2022, J CLIN ONCOL, V40, pE16131
[2]   Heterogeneity of Patients with Intermediate (BCLC B) Hepatocellular Carcinoma: Proposal for a Subclassification to Facilitate Treatment Decisions [J].
Bolondi, Luigi ;
Burroughs, Andrew ;
Dufour, Jean-Francois ;
Galle, Peter R. ;
Mazzaferro, Vincenzo ;
Piscaglia, Fabio ;
Raoul, Jean Luc ;
Sangro, Bruno .
SEMINARS IN LIVER DISEASE, 2012, 32 (04) :348-359
[3]  
Bray F, 2018, CA-CANCER J CLIN, V68, P394, DOI [10.3322/caac.21609, 10.3322/caac.21492]
[4]   Evidence-Based Diagnosis, Staging, and Treatment of Patients With Hepatocellular Carcinoma [J].
Bruix, Jordi ;
Reig, Maria ;
Sherman, Morris .
GASTROENTEROLOGY, 2016, 150 (04) :835-853
[5]   Optimizing the management of patients with BCLC stage-B hepatocellular carcinoma: Modern surgical resection as a feasible alternative to transarterial chemoemolization [J].
Ciria, R. ;
Lopez-Cillero, P. ;
Gallardo, A. -B. ;
Cabrera, J. ;
Pleguezuelo, M. ;
Ayllon, M. -D. ;
Luque, A. ;
Zurera, L. ;
Espejo, J. -J. ;
Rodriguez-Peralvarez, M. ;
Montero, J. -L. ;
de la Mata, M. ;
Briceno, J. .
EJSO, 2015, 41 (09) :1153-1161
[6]   Advances in hepatectomy technique: Toward zero transfusions in the modern era of liver surgery [J].
Day, Ryan W. ;
Brudvik, Kristoffer W. ;
Vauthey, Jean-Nicolas ;
Conrad, Claudius ;
Gottumukkala, Vijaya ;
Chun, Yun-Shin ;
Katz, Matthew H. ;
Fleming, Jason B. ;
Lee, Jeffrey E. ;
Aloia, Thomas A. .
SURGERY, 2016, 159 (03) :793-801
[7]  
EDMONDSON HA, 1954, CANCER-AM CANCER SOC, V7, P462, DOI 10.1002/1097-0142(195405)7:3<462::AID-CNCR2820070308>3.0.CO
[8]  
2-E
[9]   Prognostic and Therapeutic Implications of Microvascular Invasion in Hepatocellular Carcinoma [J].
Erstad, Derek J. ;
Tanabe, Kenneth K. .
ANNALS OF SURGICAL ONCOLOGY, 2019, 26 (05) :1474-1493
[10]  
European Assoc Study Liver, 2012, EUR J CANCER, V48, P599, DOI [10.1016/j.ejca.2011.12.021, 10.1016/j.jhep.2011.12.001]