4.4 Article

Survival benefit of adjuvant transcatheter arterial chemoembolization for patients with hepatocellular carcinoma after anatomical hepatectomy

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TAYLOR & FRANCIS LTD
DOI: 10.1080/17474124.2023.2192479

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Hepatocellular carcinoma; hepatectomy; transcatheter arterial chemoembolization; adjuvant therapy; survival

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This study aimed to evaluate the survival benefit of adjuvant transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) after anatomical hepatectomy (AH). The results showed that patients who received adjuvant TACE had better overall survival (OS) and recurrence-free survival (RFS). Therefore, adjuvant TACE should be considered for patients with a high risk of recurrence.
Background & aimsAlthough anatomical hepatectomy (AH) is widely used in the treatment of hepatocellular carcinoma (HCC), the prognosis is still unsatisfactory. The present study aimed to evaluate the survival benefit of adjuvant transcatheter arterial chemoembolization (TACE) for patients with HCC after AH.MethodsA total of 832 patients were stratified into with adjuvant TACE (443, 53.2%) and without adjuvant TACE group (389, 46.8%) AH. Propensity score matching (PSM) was performed to control for confounding factors, and multivariable Cox regression was performed to determine the independent risk factors.ResultsAfter PSM, the results showed that the adjuvant TACE group had better overall survival (OS) and recurrence-free survival (RFS). Among the patients with tumor recurrence, adjuvant TACE was associated with a high rate of early-stage tumor at recurrence, a lower recurrence rate around the frontal margin and extrahepatic metastases, and a higher rate of receiving curative treatment. Multivariable Cox regression analysis showed that adjuvant TACE was an independent prognostic factor for OS (HR 0.673, P = 0.001) and RFS (HR 0.650, P = 0.001).ConclusionsPatients with HCC after AH can benefit from postoperative adjuvant TACE. Therefore, adjuvant TACE should be considered for patients with a high risk of recurrence.

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