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Comparison of Arterial Infusion Chemotherapy and Chemoembolization for Locally Advanced Hepatocellular Carcinoma: a Multicenter Retrospective Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Unresectable hepatocellular carcinoma (HCC) has a poor prognosis. We aimed to evaluate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) for locally advanced HCC compared to transcatheter arterial chemoembolization (TACE).

Methods

A propensity score–matched cohort study was performed in patients with locally advanced HCC with ≥ 4 tumors or portal vein tumor thrombosis (PVTT) who underwent either HAIC using oxaliplatin plus raltitrexed or TACE at three institutions between June 2015 and December 2021. Overall survival (OS), progression-free survival (PFS), objective response rates (ORR), and adverse events (AEs) were compared between the groups.

Results

After propensity score matching, 62 pairs of patients were evaluated. The HAIC group had longer OS (15.0 [95% CI: 12.1–17.9] vs. 9.0 [95% CI: 5.1–12.9] months; P = 0.034), better PFS (6.7 [95% CI: 5.1–8.3] vs. 4.0 [95% CI: 2.6–5.4] months; P = 0.020), and a higher ORR (RECIST 1.1: 54.8% vs. 11.3%; P < 0.001) than the TACE group in the intention-to-treat population. Compared with the TACE group, Grade 1–2 nausea and vomiting occurred significantly more frequently in the HAIC group.

Conclusion

Compared to TACE, HAIC significantly increased the ORR of locally advanced HCC with multiple tumors or portal invasion and prolonged survival without causing a significant increase in severe AEs.

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Acknowledgements

The authors thank everyone at our institution who helped with this study.

Funding

The work was supported by the Guiding Project of Science and Technology Program of Fujian Province, China [grant number: 2019Y0060].

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Author notes

  1. Shiguang Chen and Bo Yuan contributed equally to this work. Chengjian and Chuanben Chen contributed equally to this work.

Authors and Affiliations

  1. Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350014, China

    Shiguang Chen, Wenchang Yu, Xiaolong Wang & Chuanben Chen

  2. Xuzhou Central Hospital, Xuzhou, China

    Bo Yuan

  3. The Second Military Medical University Affiliated Eastern Hepatobiliary Hospital, Shanghai, China

    Chengjian He

Authors
  1. Shiguang Chen
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  2. Bo Yuan
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  4. Xiaolong Wang
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  5. Chengjian He
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  6. Chuanben Chen
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Contributions

Conceptualization, S.C. (Shiguang Chen), C.C. (Chuanben Chen), and C.H. (Chengjian He); data curation, S.C., C.H., B.Y., W.Y. (Wenchang Yu), and X.W. (Xiaolong Wang); funding acquisition, S.C.; investigation, W.Y.; methodology, S.C. and X.W.; project administration, C.C.; software, X.W.; supervision, C.C.; writing—original draft, all authors; writing—review and editing, all authors. All authors were involved in the approval of the report and the decision to submit for publication.

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Correspondence to Chuanben Chen.

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Chen, S., Yuan, B., Yu, W. et al. Comparison of Arterial Infusion Chemotherapy and Chemoembolization for Locally Advanced Hepatocellular Carcinoma: a Multicenter Retrospective Study. J Gastrointest Surg 26, 2292–2300 (2022). https://doi.org/10.1007/s11605-022-05421-x

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  • DOI: https://doi.org/10.1007/s11605-022-05421-x

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