Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study
Qizhen Huang,1,* Kongying Lin,2,* Lei Wang,1,* Jianxing Zeng,2 Hongzhi Liu,2 Zongren Ding,2 Yongyi Zeng,2 Jingfeng Liu2 1Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Hepatopancreatobiliary...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-09-01
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| Series: | Cancer Management and Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/postoperative-adjuvant-transarterial-chemoembolization-improves-short--peer-reviewed-article-CMAR |
| _version_ | 1818408450656305152 |
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| author | Huang Q Lin K Wang L Zeng J Liu H Ding Z Zeng Y Liu J |
| author_facet | Huang Q Lin K Wang L Zeng J Liu H Ding Z Zeng Y Liu J |
| author_sort | Huang Q |
| collection | DOAJ |
| description | Qizhen Huang,1,* Kongying Lin,2,* Lei Wang,1,* Jianxing Zeng,2 Hongzhi Liu,2 Zongren Ding,2 Yongyi Zeng,2 Jingfeng Liu2 1Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jingfeng LiuDepartment of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of ChinaEmail drjingfeng@126.comPurpose: To evaluate the effect of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of hepatocellular carcinoma (HCC) with macroscopic bile duct tumor thrombus (BDTT).Patients and Methods: This study included 109 patients who underwent R0 resection for HCC with BDTT between January 2008 and December 2017: non-TACE (48) and PA-TACE (61). Propensity-score matching (PSM) was conducted in a 1:1 ratio. Recurrence and overall survival (OS) rates were analyzed using the Kaplan–Meier method. Independent risk factors were identified by univariate and multivariate Cox regression analyses. Subgroup analysis was performed by risk-factor stratification.Results: The recurrence rates in the non-TACE and PA-TACE groups were different at 6 months (50.9% vs 26.9%, P=0.03) before PSM and at 6 months (59.3% vs 26.5%, P=0.02) and 12 months (81.4% vs 37.5%, P=0.022) after PSM. OS rates of the non-TACE and PA-TACE groups were different at 6 months (74.0% vs 91.6%, P< 0.001) and 12 months (61.1% vs 77.6%, P=0.01) before PSM and at 6 months (73.0% vs 96.8%, P=0.01), 12 months (52.1% vs 89.6%, P=0.001), and 18 months (33.8% vs 64.4%, P=0.034) after PSM. PA-TACE was an independent prognostic factor for both recurrence and OS before and after PSM. Subgroup analysis showed that patients with no HBV infection, tumors > 5 cm, macrovascular invasion, alpha-fetoprotein (AFP) > 400 ng/mL, or gamma-glutamyl transferase (GGT) > 150 U/L benefited significantly from PA-TACE in terms of recurrence rates (all P< 0.05). Patients with no HBV infection, multiple tumors, tumors > 5 cm, macrovascular invasion, or AFP > 400 ng/mL benefited significantly from PA-TACE in terms of OS (all P< 0.05).Conclusion: PA-TACE could prolong the short-term prognosis of HCC with macroscopic BDTT and should be recommended for patients with no HBV infection, multiple tumors, tumors > 5 cm, poor differentiation, macrovascular invasion, AFP > 400 ng/mL, or GGT > 150 U/L.Keywords: hepatocellular carcinoma, bile duct tumor thrombus, transarterial chemoembolization, recurrence, survival |
| first_indexed | 2024-12-14T09:43:56Z |
| format | Article |
| id | doaj.art-a7feea3855734132bf37b2f0277f97d8 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-14T09:43:56Z |
| publishDate | 2020-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-a7feea3855734132bf37b2f0277f97d82022-12-21T23:07:43ZengDove Medical PressCancer Management and Research1179-13222020-09-01Volume 129183919557465Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching StudyHuang QLin KWang LZeng JLiu HDing ZZeng YLiu JQizhen Huang,1,* Kongying Lin,2,* Lei Wang,1,* Jianxing Zeng,2 Hongzhi Liu,2 Zongren Ding,2 Yongyi Zeng,2 Jingfeng Liu2 1Department of Radiation Oncology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jingfeng LiuDepartment of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, People’s Republic of ChinaEmail drjingfeng@126.comPurpose: To evaluate the effect of postoperative adjuvant transarterial chemoembolization (PA-TACE) on the prognosis of hepatocellular carcinoma (HCC) with macroscopic bile duct tumor thrombus (BDTT).Patients and Methods: This study included 109 patients who underwent R0 resection for HCC with BDTT between January 2008 and December 2017: non-TACE (48) and PA-TACE (61). Propensity-score matching (PSM) was conducted in a 1:1 ratio. Recurrence and overall survival (OS) rates were analyzed using the Kaplan–Meier method. Independent risk factors were identified by univariate and multivariate Cox regression analyses. Subgroup analysis was performed by risk-factor stratification.Results: The recurrence rates in the non-TACE and PA-TACE groups were different at 6 months (50.9% vs 26.9%, P=0.03) before PSM and at 6 months (59.3% vs 26.5%, P=0.02) and 12 months (81.4% vs 37.5%, P=0.022) after PSM. OS rates of the non-TACE and PA-TACE groups were different at 6 months (74.0% vs 91.6%, P< 0.001) and 12 months (61.1% vs 77.6%, P=0.01) before PSM and at 6 months (73.0% vs 96.8%, P=0.01), 12 months (52.1% vs 89.6%, P=0.001), and 18 months (33.8% vs 64.4%, P=0.034) after PSM. PA-TACE was an independent prognostic factor for both recurrence and OS before and after PSM. Subgroup analysis showed that patients with no HBV infection, tumors > 5 cm, macrovascular invasion, alpha-fetoprotein (AFP) > 400 ng/mL, or gamma-glutamyl transferase (GGT) > 150 U/L benefited significantly from PA-TACE in terms of recurrence rates (all P< 0.05). Patients with no HBV infection, multiple tumors, tumors > 5 cm, macrovascular invasion, or AFP > 400 ng/mL benefited significantly from PA-TACE in terms of OS (all P< 0.05).Conclusion: PA-TACE could prolong the short-term prognosis of HCC with macroscopic BDTT and should be recommended for patients with no HBV infection, multiple tumors, tumors > 5 cm, poor differentiation, macrovascular invasion, AFP > 400 ng/mL, or GGT > 150 U/L.Keywords: hepatocellular carcinoma, bile duct tumor thrombus, transarterial chemoembolization, recurrence, survivalhttps://www.dovepress.com/postoperative-adjuvant-transarterial-chemoembolization-improves-short--peer-reviewed-article-CMARhepatocellular carcinomabile duct tumor thrombustransarterial chemoembolizationrecurrencesurvival. |
| spellingShingle | Huang Q Lin K Wang L Zeng J Liu H Ding Z Zeng Y Liu J Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study Cancer Management and Research hepatocellular carcinoma bile duct tumor thrombus transarterial chemoembolization recurrence survival. |
| title | Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study |
| title_full | Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study |
| title_fullStr | Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study |
| title_full_unstemmed | Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study |
| title_short | Postoperative Adjuvant Transarterial Chemoembolization Improves Short-Term Prognosis of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Propensity-Score Matching Study |
| title_sort | postoperative adjuvant transarterial chemoembolization improves short term prognosis of hepatocellular carcinoma with bile duct tumor thrombus a propensity score matching study |
| topic | hepatocellular carcinoma bile duct tumor thrombus transarterial chemoembolization recurrence survival. |
| url | https://www.dovepress.com/postoperative-adjuvant-transarterial-chemoembolization-improves-short--peer-reviewed-article-CMAR |
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