Transarterial Chemoembolization for Patients with Unresectable Hepatocellular Carcinoma with Child-Pugh B7

Abstract

Jian-Qiang Jiang,1,2,* Jin-Tao Huang,1,* Bin-Yan Zhong,1 Wei-Dong Wang,3,* Jun-Hui Sun,4 Qi Wang,5 Wen-Bin Ding,6 Cai-Fang Ni,1 Xiao-Li Zhu1 1Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2Department of Interventional Therapy, Nantong Tumor Hospital, Nantong, People’s Republic of China; 3Department of Interventional Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, People’s Republic of China; 4Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 5Department of Interventional Radiology, Third Affiliated Hospital of Soochow University, Changzhou First Hospital, Changzhou, People’s Republic of China; 6Department of Interventional Radiology, Nantong First People’s Hospital, Nantong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiao-Li Zhu; Bin-Yan Zhong, Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, 188 Shizi St, Suzhou, 215006, People’s Republic of China, Tel/Fax [phone], Email [email protected]; [email protected] and Objectives: This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) in patients with unresectable early or intermediate hepatocellular carcinoma (HCC) and Child-Pugh (CP)-B liver dysfunction.Methods: This multicenter retrospective study enrolled patients with treatment-naïve HCC treated with TACE monotherapy between January 2012 and December 2020 at six Chinese hospitals. The primary outcome was overall survival (OS), and the secondary outcomes included the objective response rate (ORR) according to the modified RECIST and adverse events (AEs). Propensity score matching (PSM) was performed to reduce bias between the CP-B and CP-A groups.Results: A total of 847 patients were included in the study. CP-A patients had significantly longer OS (median, 22.0 vs 19.3 months, P = 0.032) than CP-B (score of 7– 9) patients, but a non-significant trend compared with CP-B (score of 7) patients (median, 22.0 vs 20.5 months, P = 0.254). After PSM, the median OS was 22.7 months for CP-A patients, while it was 19.3 months for CP-B (score of 7– 9) patients (p = 0.026) and 20.5 months for CP-B (score of 7) patients (p = 0.155). CP-A patients achieved a significantly better ORR (53.0% vs 35.8%, P 0.05). The post-embolization syndrome rates in the CP-A and CP-B (score of 7) cohorts were 52.1% and 53.3%, respectively. No new safety concerns were observed.Conclusion: Patients with HCC with a CP score of 7 receiving TACE showed a similar prognosis and safety profile to CP-A patients.Keywords: hepatocellular carcinoma, transarterial chemoembolization, Child-Pugh grade

Keywords

• hepatocellular carcinoma
• transarterial chemoembolization
• child-pugh grade