Abstract
BackgroundTransarterial chemoembolization (TACE) is an effective treatment for patients with hepatocellular carcinoma (HCC). However, the impact of hepatitis B viral (HBV) infection and body mass index (BMI) on TACE is controversial. The present study aimed to compare the influence of HBV and high BMI on TACE outcomes in advanced HCC.MethodsBased on HBV infection history and BMI, patients were assigned to different subgroups. Blood samples were collected and analyzed by an enzyme-linked immunosorbent assay (ELISA) kit. The primary endpoint was progression-free survival (PFS) and the overall survival (OS) in the population.ResultsCompared to overweight combined HBV patients who received TACE, people with normal weight or no viral infection had significantly better OS and PFS. Sex, age, portal vein tumor thrombus, BCLC, ECOG, and tumor diameter are the main risk factors affecting PFS and OS. Except for the postoperative fever, no significant difference was detected in adverse reactions. Irrespective of TACE, the average expression of HMGB1 in hepatitis or obesity patients was higher than that in normal individuals and did not show upregulation after TACE. Patients without overweight or HBV infection had a low expression of serum HMGB1 that was substantially upregulated after TACE.ConclusionsIn this study, overweight combined HBV infection patients had shorter PFS and OS than other HCC patients. Thus, HBV and BMI maybe two factors affecting the efficacy of TACE via upregulated HMGB1.
Highlights
Transarterial chemoembolization (TACE) is an effective treatment for patients with hepatocellular carcinoma (HCC)
High body mass index (BMI) combined with hepatitis B viral (HBV) infection has a negative impact on the progression-free survival (PFS) and overall survival (OS) of HCC patients treated with TACE. 2
Irrespective of TACE, the average Human high mobility group 1 (HMGB1) in hepatitis and obesity patients was higher than that in normal individuals, which was not upregulated after TACE. 3
Summary
Transarterial chemoembolization (TACE) is an effective treatment for patients with hepatocellular carcinoma (HCC). The impact of hepatitis B viral (HBV) infection and body mass index (BMI) on TACE is controversial. Primary liver cancer is one of the highest mortality cancers of the digestive system in Asia It is the third most common cause of cancer-related deaths worldwide [1]. Overweight is associated with liver disease and has long been considered a major cause of HCC, our understanding of the role of body mass index (BMI) and hepatitis B virus (HBV) infection in cancer treatment is limited [8,9,10]. Recent studies have reported that obesity associated with viral infection increases both the risk and the rate of HCC progression. With the increase in obesity and the incidence of these diseases, obese patients with HCC have become common
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