Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy
BackgroundTo identify whether adjuvant transarterial chemoembolization (TACE) can improve prognosis in HCC patients with a low risk of recurrence (tumor size ≤ 5 cm, single nodule, no satellites, and no microvascular or macrovascular invasions) after hepatectomy.MethodsThe data of 489 HCC patients w...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1104492/full |
| _version_ | 1827942100507820032 |
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| author | Long-Hai Feng Long-Hai Feng Yu-Yao Zhu Jia-Min Zhou Jia-Min Zhou Miao Wang Miao Wang Wei-Qi Xu Wei-Qi Xu Ti Zhang Ti Zhang An-Rong Mao An-Rong Mao Wen-Ming Cong Hui Dong Lu Wang Lu Wang |
| author_facet | Long-Hai Feng Long-Hai Feng Yu-Yao Zhu Jia-Min Zhou Jia-Min Zhou Miao Wang Miao Wang Wei-Qi Xu Wei-Qi Xu Ti Zhang Ti Zhang An-Rong Mao An-Rong Mao Wen-Ming Cong Hui Dong Lu Wang Lu Wang |
| author_sort | Long-Hai Feng |
| collection | DOAJ |
| description | BackgroundTo identify whether adjuvant transarterial chemoembolization (TACE) can improve prognosis in HCC patients with a low risk of recurrence (tumor size ≤ 5 cm, single nodule, no satellites, and no microvascular or macrovascular invasions) after hepatectomy.MethodsThe data of 489 HCC patients with a low risk of recurrence after hepatectomy from Shanghai Cancer Center (SHCC) and Eastern Hepatobiliary Surgery Hospital (EHBH) were retrospectively reviewed. Recurrence-free survival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier curves and Cox proportional hazards regression models. The effects of selection bias and confounding factors were balanced using propensity score matching (PSM).ResultsIn the SHCC cohort, 40 patients (19.9%, 40/201) received adjuvant TACE, and in the EHBH cohort, 113 patients (46.2%, 133/288) received adjuvant TACE. Compared to the patients without adjuvant TACE after hepatectomy, patients receiving adjuvant TACE had significantly shorter RFS (P=0.022; P=0.014) in both cohorts before PSM. However, no significant difference existed in OS (P=0.568; P=0.082). Multivariate analysis revealed that serum alkaline phosphatase and adjuvant TACE were independent prognostic factors for recurrence in both cohorts. Furthermore, significant differences existed in tumor size between the adjuvant TACE and non-adjuvant TACE groups in the SHCC cohort. There were differences in transfusion, Barcelona Clinic Liver Cancer stage and tumor-node-metastasis stage in the EHBH cohort. These factors were balanced by PSM. After PSM, patients with adjuvant TACE after hepatectomy still had significantly shorter RFS than those without (P=0.035; P=0.035) in both cohorts, but there was no difference in OS (P=0.638; P=0.159). Adjuvant TACE was the only independent prognostic factor for recurrence in multivariate analysis, with hazard ratios of 1.95 and 1.57.ConclusionsAdjuvant TACE may not improve long-term survival and might promote postoperative recurrence in HCC patients with a low risk of recurrence after hepatectomy. |
| first_indexed | 2024-03-13T09:53:35Z |
| format | Article |
| id | doaj.art-6da85b3bff7c4228bd1922d1b123a953 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T09:53:35Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6da85b3bff7c4228bd1922d1b123a9532023-05-24T05:06:36ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11044921104492Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomyLong-Hai Feng0Long-Hai Feng1Yu-Yao Zhu2Jia-Min Zhou3Jia-Min Zhou4Miao Wang5Miao Wang6Wei-Qi Xu7Wei-Qi Xu8Ti Zhang9Ti Zhang10An-Rong Mao11An-Rong Mao12Wen-Ming Cong13Hui Dong14Lu Wang15Lu Wang16Department of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, ChinaDepartment of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, ChinaDepartment of Hepatic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaBackgroundTo identify whether adjuvant transarterial chemoembolization (TACE) can improve prognosis in HCC patients with a low risk of recurrence (tumor size ≤ 5 cm, single nodule, no satellites, and no microvascular or macrovascular invasions) after hepatectomy.MethodsThe data of 489 HCC patients with a low risk of recurrence after hepatectomy from Shanghai Cancer Center (SHCC) and Eastern Hepatobiliary Surgery Hospital (EHBH) were retrospectively reviewed. Recurrence-free survival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier curves and Cox proportional hazards regression models. The effects of selection bias and confounding factors were balanced using propensity score matching (PSM).ResultsIn the SHCC cohort, 40 patients (19.9%, 40/201) received adjuvant TACE, and in the EHBH cohort, 113 patients (46.2%, 133/288) received adjuvant TACE. Compared to the patients without adjuvant TACE after hepatectomy, patients receiving adjuvant TACE had significantly shorter RFS (P=0.022; P=0.014) in both cohorts before PSM. However, no significant difference existed in OS (P=0.568; P=0.082). Multivariate analysis revealed that serum alkaline phosphatase and adjuvant TACE were independent prognostic factors for recurrence in both cohorts. Furthermore, significant differences existed in tumor size between the adjuvant TACE and non-adjuvant TACE groups in the SHCC cohort. There were differences in transfusion, Barcelona Clinic Liver Cancer stage and tumor-node-metastasis stage in the EHBH cohort. These factors were balanced by PSM. After PSM, patients with adjuvant TACE after hepatectomy still had significantly shorter RFS than those without (P=0.035; P=0.035) in both cohorts, but there was no difference in OS (P=0.638; P=0.159). Adjuvant TACE was the only independent prognostic factor for recurrence in multivariate analysis, with hazard ratios of 1.95 and 1.57.ConclusionsAdjuvant TACE may not improve long-term survival and might promote postoperative recurrence in HCC patients with a low risk of recurrence after hepatectomy.https://www.frontiersin.org/articles/10.3389/fonc.2023.1104492/fullhepatocellular carcinomahepatectomypostoperative adjuvant TACElow risk of recurrenceprognosis |
| spellingShingle | Long-Hai Feng Long-Hai Feng Yu-Yao Zhu Jia-Min Zhou Jia-Min Zhou Miao Wang Miao Wang Wei-Qi Xu Wei-Qi Xu Ti Zhang Ti Zhang An-Rong Mao An-Rong Mao Wen-Ming Cong Hui Dong Lu Wang Lu Wang Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy Frontiers in Oncology hepatocellular carcinoma hepatectomy postoperative adjuvant TACE low risk of recurrence prognosis |
| title | Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy |
| title_full | Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy |
| title_fullStr | Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy |
| title_full_unstemmed | Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy |
| title_short | Adjuvant TACE may not improve recurrence-free or overall survival in HCC patients with low risk of recurrence after hepatectomy |
| title_sort | adjuvant tace may not improve recurrence free or overall survival in hcc patients with low risk of recurrence after hepatectomy |
| topic | hepatocellular carcinoma hepatectomy postoperative adjuvant TACE low risk of recurrence prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1104492/full |
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