Abstract
ObjectivesThe purpose of this study was to evaluate the efficacy and safety of transarterial chemoembolization (TACE) in the treatment of patients with treatment-naïve hepatocellular carcinoma (TN-HCC) and recurrent HCC (R-HCC). In addition, risk signature analysis was performed to accurately assess patients’ recurrence and survival.MethodsThis retrospective study assessed the consecutive medical records of TN-HCC and R-HCC patients from January 2014 to December 2018. In order to reduce the patient selection bias, propensity score matching (PSM) analysis was applied. Conditional inference tree was used to establish a risk signature.ResultsA total of 401 eligible patients were included in our study, including 346 patients in the TN-HCC group and 55 patients in the R-HCC group. Forty-seven pairs of patients were chosen after the PSM analysis. Before the PSM analysis, the objective tumor regression (ORR) and disease control rate (DCR) of R-HCC patients were better than that of TN-HCC patients; however, after the PSM analysis, there was no significant difference in the ORR and DCR between the two groups (P>0.05). Before the PSM analysis, the median overall survival (OS) and progression-free survival (PFS) in the R-HCC group were significantly greater than those of the TN-HCC group (OS: 24 months vs. 18 months, P =0.004; PFS: 9 months vs. 6 months, P =0.012). However, after the PSM analysis, the median OS and PFS in the R-HCC group were inferior to those in the TN-HCC group (OS: 24 months vs. 33 months, P= 0.0035; PFS: 10 months vs. 12 months, P = 0.01). The conditional inference tree divided patients into different subgroups according to tumor size, BCLC stage, and TACE sessions and shared different hazards ratio to recurrence or survival.ConclusionPatients with R-HCC treated with TACE achieved satisfactory results, although survival after the PSM analysis was not as good as in the TN-HCC group. In addition, risk signature based on conditional inference tree analysis can more accurately predict the recurrence and survival in both groups of patients.
Highlights
Hepatocellular carcinoma (HCC) is the fifth most common cancer and one of the most frequent causes of cancer-related death [1]
Transarterial chemoembolization (TACE) has been reported in patients with BCLC stage C HCC, and the results indicated that TACE can benefit these patients [9, 10]
From January 2014 to December 2018, a total of 401 patients were included in our study, including 346 treatment-naïve HCC (TN-HCC) patients and 55 patients with recurrent HCC (R-HCC)
Summary
Hepatocellular carcinoma (HCC) is the fifth most common cancer and one of the most frequent causes of cancer-related death [1]. Especially in China, the prognosis of HCC patients remains a depressing issue Therapies such as liver resection (LR) and liver transplantation have the potential to cure patients with preserved liver function, but these curative therapies only benefit a quarter of HCC patients [2, 3]. Intrahepatic recurrence and de novo tumor emergence in the liver remnant after LR are common, with a 5year recurrence rate of up to 70%-80% [4]. This is a common clinical manifestation, there is still no consensus on the treatment of recurrent HCC (R-HCC) after LR, which remains a thorny issue that currently confounds clinicians and patients. Only a small number of patients benefit from curative treatments, which may create an incentive to try other therapies and approaches
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
