Abstract
Background and aimsThis study aimed to determine the relationship between Ki67 expression and the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with hepatocellular carcinoma.MethodsThe Kaplan-Meier method was used to analyze the recurrence-free survival (RFS) and overall survival (OS) rates between the sub-groups in the ki67 low expression group and the ki67 high expression group and analyze the relationship between the expression of Ki67 and the efficacy of TACE.ResultsAfter PSM, there was no significant difference in the RFS and OS between the surgery + TACE and surgery subgroups after 1, 2, or 3 years (RFS: 63.9%, 55.6%, and 42.9% vs. 83.3%, 63.9%, and 55.6%, respectively, P = 0.279; OS: 91.7%, 83.3%, and 74.3% vs. 91.7%, 88.9%, and 71.4%, respectively, P = 0.890) in the Ki67 low-expression group. The RFS and OS were higher in the surgery + TACE subgroup than the surgery subgroup after 1, 2, and 3 years (RFS: 80.0%, 77.5%, and 69.2% vs. 53.5%, 39.5%, and 32.6%, respectively, P<0.001; OS: 97.5%, 85.0%, and 79.5% vs. 79.1%, 48.8%, and 42.9%, respectively, P = 0.001) in the Ki67 high expression group. The RFS was higher in the Ki67 high-expression subgroup than the low-expression subgroup after 1, 2, and 3 years, and OS had no significant difference (RFS: 80.0%, 79.5%, and 69.2% vs. 67.4%, 56.5%, and 46.7%, respectively, P = 0.035; OS: 97.5%, 85.0%, and 79.5% vs. 93.5%, 82.6%, and 75.6%, respectively, P = 0.665) in the surgery + TACE group.ConclusionsFor patients with hepatocellular carcinoma and high expression of Ki67 (Ki67≥20%), adjuvant hepatic artery chemoembolization after radical liver tumor resection effectively reduced the probability of tumor recurrence after surgery and prolonged the OS of patients. High Ki67 expression during the post-operative follow-up evaluation of hepatocellular carcinoma patients is an indicator for adjuvant TACE therapy.
Highlights
For patients with hepatocellular carcinoma and high expression of Ki67 (Ki67≥20%), adjuvant hepatic artery chemoembolization after radical liver tumor resection effectively reduced the probability of tumor recurrence after surgery and prolonged the overall survival (OS) of patients
High Ki67 expression during the post-operative follow-up evaluation of hepatocellular carcinoma patients is an indicator for adjuvant transcatheter arterial chemoembolization (TACE) therapy
A radical liver resection is currently the most effective way to treat patients with hepatocellular carcinoma (HCC) [1], and studies have shown that the recurrence rate of patients undergoing radical liver resection alone is approximately 70% 5 years after surgery, while the 5-year survival rate is decreased by 24% in patients with a HCC recurrence compared to patients without a recurrence [2]
Summary
A radical liver resection is currently the most effective way to treat patients with hepatocellular carcinoma (HCC) [1], and studies have shown that the recurrence rate of patients undergoing radical liver resection alone is approximately 70% 5 years after surgery, while the 5-year survival rate is decreased by 24% in patients with a HCC recurrence compared to patients without a recurrence [2]. The median survival time is decreased by 54 months in patients with a HCC recurrent [2]. Postoperative adjuvant treatment can effectively delay tumor recurrence and prolong the survival of patients. Transcatheter arterial chemoembolization (TACE) is currently the most widely used adjuvant treatment program for patients with HCC [3]. The development of a precise standard will facilitate clinical decision-making and treat patients in a timely fashion, improving the postoperative tumor recurrence and survival rates. This study aimed to determine the relationship between Ki67 expression and the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with hepatocellular carcinoma
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