Survival benefit of radiotherapy following narrow-margin hepatectomy in patients with hepatocellular carcinoma: A propensity score-matched analysis based on phase II study

Background and purpose: We evaluated the postoperative radiotherapy (PORT) effects on hepatocellular carcinoma (HCC) prognosis and recurrence in patients who underwent narrow-margin (<1.0 cm) hepate-ctomy (NH).Materials and methods: This two-arm cohort study based on the phase II study compared NH with or without PORT in patients with HCC. All patients underwent NH; 76 patients who received PORT following NH in the phase II study were assigned to the NH + RT group, and 171 who underwent NH alone were assigned to the NH group. Propensity score matching (PSM) was used to balance clinicopathological char-acteristic differences between groups.Results: Before PSM, the 5-year overall survival (OS) rates between groups differed significantly (72.2 % vs 60.7 %, P = 0.017). Moreover, the 5-year disease-free survival (DFS) rate was significantly higher in the NH + RT group (51.4 % vs 35.7 %, P = 0.002). After PSM, the between-group difference in OS rates remained high (P = 0.045); the 5-year OS rates were 74.7 % and 63.6 % in the NH + RT and NH groups, respectively. Similarly, the DFS rate remained significantly higher in the NH + RT group (P = 0.001); the 5-year DFS rates were 56.3 % and 31.6 %, respectively. Furthermore, both before and after PSM, patients in the NH + RT group showed significantly lower early, intrahepatic, and extrahepatic recurrence rates than those in the NH group.Conclusions: PORT may have significant OS and DFS benefits in patients with HCC undergoing NH.(c) 2023 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology xxx (2023) xxx-xxx This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study evaluated the effects of postoperative radiotherapy (PORT) on prognosis and recurrence in patients with hepatocellular carcinoma (HCC) who underwent narrow-margin hepatectomy (NH). The results showed that the PORT group had significantly higher 5-year overall survival and disease-free survival rates compared to the non-PORT group, and the tumor recurrence rate was lower in the PORT group. Therefore, postoperative radiotherapy may have significant benefits in the treatment of HCC.