Postoperative adjuvant transarterial chemoembolisation improves survival of hepatocellular carcinoma patients with microvascular invasion: A multicenter retrospective cohort

Luo, Laihui1; Shan, Renfeng1; Cui, Lifeng2,3,4; Wu, Zhao5; Qian, Junlin; Tu, Shuju1; Zhang, WenJian5; Xiong, Yuanpeng1; Lin, Wei6; Tang, Hongtao6; Zhang, Yang1; Zhu, Jisheng1; Huang, Zeyu5; Li, Zhigang5; Mao, Shengping5; Li, Hui7; Hu, Zemin6; Peng, Peng6; He, Kun6; Li, Yong1,8; Liu, Liping2,3,10,11; Shen, Wei5,12; He, Yongzhu1,6,8,9

2023-03-01

10.1002/ueg2.12365

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL   Impact Factor & Quartile

2050-6406

2050-6414

BackgroundWe aimed to investigate the efficacy of postoperative adjuvant transarterial chemoembolisation (PA-TACE) in patients with hepatocellular carcinoma (HCC) complicated by microvascular invasion (MVI). MethodsA retrospective analysis of 1505 patients with HCC who underwent hepatectomy at four medical centers, including 782 patients who received PA-TACE and 723 patients who did not receive adjuvant PA-TACE, has been conducted. Propensity score matching (PSM) (1:1) was performed on the data to minimise selection bias, which resulted in a balanced clinical profile between groups. ResultsAfter PSM, 620 patients who received PA-TACE and 620 patients who did not receive PA-TACE were included. Disease-free survival (DFS, 1-, 2-, and 3-year: 88%-68%-61% vs. 70%-58%-51%, p < 0.001) and overall survival (OS, 1-, 2-, and 3-year: 96%-89%-82% vs. 89%-77%-67%, p < 0.001) were significantly higher in patients who received PA-TACE than in those who did not. Patients with MVI who received PA-TACE had significantly higher DFS (1-, 2-, and 3-year: 68%-57%-48% vs. 46%-31%-27%, p < 0.001) and OS (1-, 2-, and 3-year: 96%-84%-77% vs. 79%-58%-40%, p < 0.001) than those who did not receive PA-TACE. Among the six different liver cancer stages, MVI-negative patients did not have significant survival outcomes from PA-TACE (p > 0.05), whereas MVI-positive patients achieved higher DFS and OS from it (p < 0.05). Liver dysfunction, fever, and nausea/vomiting were the most common adverse events in patients receiving PA-TACE. There was no significant difference in grade 3 or 4 adverse events between the groups (p > 0.05). ConclusionsPostoperative adjuvant transarterial chemoembolisation has a good safety profile and may be a potentially beneficial treatment modality for survival outcomes in patients with HCC, especially those with concomitant MVI.

adjuvant HCC hepatectomy hepatocellular carcinoma microvascular invasion propensity score survival TACE transarterial chemoembolisation

SCI

English

Corresponding

Zhongshan Science and Technology Plan Project of Guangdong Province[2021B1040] ; Natural Science Foundation of Jiangxi Provincial[20171BAB205064] ; National Natural Science Foundation of China[81860432] ; Key research and development projects of Jiangxi Provincial Department of Science and Technology[20202BBGL73092]

Gastroenterology & Hepatology

Gastroenterology & Hepatology

WOS:000951561000001

JOHN WILEY & SONS LTD

Web of Science

1.Nanchang Univ, Div Hepatobiliary & Pancreas Surg, Dept Gen Surg, Affiliated Hosp 1,Clin Med Coll 1, Nanchang City, Jiangxi Provinc, Peoples R China
2.Jinan Univ, Div Hepatobiliary & Pancreas Surg, Dept Gen Surg, Shenzhen Peoples Hosp,Clin Med Coll 2, Shenzhen, Guangdong Provi, Peoples R China
3.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen, Guangdong Provi, Peoples R China
4.Maoming Peoples Hosp, Maoming, Peoples R China
5.Nanchang Univ, Dept Gen Surg, Clin Med Coll 2, Affiliated Hosp 2, Nanchang City, Jiangxi Provinc, Peoples R China
6.Sun Yat sen Univ, Zhongshan Peoples Hosp, Dept Hepatobiliary Surg, Zhongshan Hosp, Zhongshan City, Guangdong Provi, Peoples R China
7.Nanchang Univ, Sch Publ Hlth, Nanchang, Peoples R China
8.Nanchang Univ, Div Hepatobiliary & Pancreas Surg, Dept Gen Surg, Clin Med Coll 1,Affiliated Hosp 1, 17 Yongwaizheng St, Nanchang City 330006, Jiangxi Provinc, Peoples R China
9.Sun Yat sen Univ, Zhongshan Peoples Hosp, Dept Hepatobiliary Surg, Zhongshan Hosp, 2 Sunwen East Rd, Zhongshan City 528400, Guangdong Provi, Peoples R China
10.Jinan Univ, Div Hepatobiliary & Pancreas Surg, Dept Gen Surg, Shenzhen Peoples Hosp,Clin Med Coll 2, 1017 Dongmen North Rd, Shenzhen 518020, Guangdong Provi, Peoples R China
11.Southern Univ Sci & Technol, Affiliated Hosp 1, 1017 Dongmen North Rd, Shenzhen 518020, Guangdong Provi, Peoples R China
12.Nanchang Univ, Dept Gen Surg, Clin Med Coll 2, Affiliated Hosp 2, 1 Minde Rd, Nanchang City 330006, Jiangxi Provinc, Peoples R China

Luo, Laihui,Shan, Renfeng,Cui, Lifeng,et al. Postoperative adjuvant transarterial chemoembolisation improves survival of hepatocellular carcinoma patients with microvascular invasion: A multicenter retrospective cohort[J]. UNITED EUROPEAN GASTROENTEROLOGY JOURNAL,2023.

Luo, Laihui.,Shan, Renfeng.,Cui, Lifeng.,Wu, Zhao.,Qian, Junlin.,...&He, Yongzhu.(2023).Postoperative adjuvant transarterial chemoembolisation improves survival of hepatocellular carcinoma patients with microvascular invasion: A multicenter retrospective cohort.UNITED EUROPEAN GASTROENTEROLOGY JOURNAL.

Luo, Laihui,et al."Postoperative adjuvant transarterial chemoembolisation improves survival of hepatocellular carcinoma patients with microvascular invasion: A multicenter retrospective cohort".UNITED EUROPEAN GASTROENTEROLOGY JOURNAL (2023).