Efficacy of adjuvant TACE on the prognosis of patients with HCC after hepatectomy: a multicenter propensity score matching from China
Zhao Wu,
Lifeng Cui,
Junlin Qian,
Laihui Luo,
Shuju Tu,
Fei Cheng,
Lebin Yuan,
WenJian Zhang,
Wei Lin,
Hongtao Tang,
Xiaodong Li,
Hui Li,
Yang Zhang,
Jisheng Zhu,
Yong Li,
Yuanpeng Xiong,
Zemin Hu,
Peng Peng,
Yongzhu He,
Liping Liu,
Kun He,
Wei Shen
Affiliations
Zhao Wu
Department of General Surgery, The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University
Lifeng Cui
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People’s Hospital, Jinan University, Southern University of Science and Technology)
Junlin Qian
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Laihui Luo
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Shuju Tu
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Fei Cheng
Department of General Surgery, The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University
Lebin Yuan
Department of General Surgery, The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University
WenJian Zhang
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People’s Hospital, Jinan University, Southern University of Science and Technology)
Wei Lin
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Hongtao Tang
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Xiaodong Li
Department of General Surgery, The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University
Hui Li
School of Public Health, Nanchang University
Yang Zhang
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Jisheng Zhu
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Yong Li
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Yuanpeng Xiong
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Zemin Hu
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Peng Peng
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Yongzhu He
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The First Clinical Medical College of Nanchang University, The First Affiliated Hospital of Nanchang University
Liping Liu
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People’s Hospital, Jinan University, Southern University of Science and Technology)
Kun He
Department of Hepatobiliary Surgery, Zhongshan People’s Hospital (Zhongshan Hospital Affiliated to Sun Yat-sen University)
Wei Shen
Department of General Surgery, The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University
Abstract Background The survival benefit of adjuvant transarterial chemoembolization (TACE) in patients with hepatectomy for hepatocellular carcinoma (HCC) after hepatectomy remains controversial. We aimed to investigate the survival efficacy of adjuvant TACE after hepatectomy for HCC. Methods 1491 patients with HCC who underwent hepatectomy between January 2018 and September 2021 at four medical centers in China were retrospectively analyzed, including 782 patients who received adjuvant TACE and 709 patients who did not receive adjuvant TACE. Propensity score matching (PSM) (1:1) was performed to minimize selection bias, which balanced the clinical characteristics of the two groups. Results A total of 1254 patients were enrolled after PSM, including 627 patients who received adjuvant TACE and 627 patients who did not receive adjuvant TACE. Patients who received adjuvant TACE had higher disease-free survival (DFS, 1- ,2-, and 3-year: 78%-68%-62% vs. 69%-57%-50%, p < 0.001) and overall survival (OS, 1- ,2-, and 3-year: 96%-88%-80% vs. 90%-77%-66%, p < 0.001) than those who did not receive adjuvant TACE (Median DFS was 39 months). Among the different levels of risk factors affecting prognosis [AFP, Lymphocyte-to-monocyte ratio, Maximum tumor diameter, Number of tumors, Child-Pugh classification, Liver cirrhosis, Vascular invasion (imaging), Microvascular invasion, Satellite nodules, Differentiation, Chinese liver cancer stage II-IIIa], the majority of patients who received adjuvant TACE had higher DFS or OS than those who did not receive adjuvant TACE. More patients who received adjuvant TACE accepted subsequent antitumor therapy such as liver transplantation, re-hepatectomy and local ablation after tumor recurrence, while more patients who did not receive adjuvant TACE accepted subsequent antitumor therapy with TACE after tumor recurrence (All p < 0.05). Conclusions Adjuvant TACE may be a potential way to monitor early tumor recurrence and improve postoperative survival in patients with HCC.
