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Annals of Surgical Oncology

, Volume 26, Issue 5, pp 1465–1473 | Cite as

Postoperative Adjuvant Transarterial Chemoembolization Improves Outcomes of Hepatocellular Carcinoma Associated with Hepatic Vein Invasion: A Propensity Score Matching Analysis

  • Xiu-Ping Zhang
  • Yan-Chen Liu
  • Zhen-Hua Chen
  • Ju-Xian Sun
  • Kang Wang
  • Zong-Tao Chai
  • Jie Shi
  • Wei-Xing Guo
  • Meng-Chao Wu
  • Wan Yee Lau
  • Shu-Qun ChengEmail author
Hepatobiliary Tumors

Abstract

Background

Vascular invasion is a major determinant of survival outcomes after curative resection for hepatocellular carcinoma (HCC) patients. This study was designed to investigate the efficacy of postoperative adjuvant transarterial chemoembolization (PA-TACE) in patients with HCC with hepatic vein tumor thrombus (HVTT).

Methods

Data from patients who underwent LR for HCC with HVTT at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed. The survival outcomes for patients who underwent PA-TACE after LR were compared with those who underwent LR alone. Propensity score matching (PSM) analysis was performed to match patients in a ratio of 1:1.

Results

All included 319 patients who underwent LR for HCC with HVTT, 134 underwent LR alone (the LR group), and 185 patients underwent in adjuvant TACE (the PA-TACE group). PSM matched 107 patients in two groups. The overall survival (OS) and recurrence-free survival (RFS) were significantly better for patients in the PA-TACE group than the LR group (for OS: before PSM, P < 0.001; after PSM, P = 0.004; for RFS: before PSM, P < 0.001; after PSM, P = 0.013), respectively. On subgroup analysis, equivalent acceptable results were obtained in patients with peripheral HVTT (pHVTT) and major HVTT (mHVTT). However, PA-TACE resulted in no survival benefits for patients when the HVTT had extended to the inferior vena cava (IVCTT).

Conclusions

PA-TACE was associated with significantly better survival outcomes than LR alone for patients with HCC and HVTT (pHVTT and mHVTT). There was no survival benefits in patients whose HVTT had extended to form IVCTT.

Notes

Authors contributions

Conception and design: Shu-Qun Cheng, Wan Yee Lau, Xiu-Ping Zhang; Financial support: Shu-Qun Cheng; Provision of study materials or patients: Ju-Xian Sun, Kang Wang, Zong-Tao Chai, Jie Shi, Wei-Xing Guo, Meng-Chao Wu; Collection and assembly of data: Xiu-Ping Zhang, Yan-Chen Liu, Zhen-Hua Chen; Data analysis and interpretation: Xiu-Ping Zhang, Yan-Chen Liu, Zhen-Hua Chen; Manuscript writing: Xiu-Ping Zhang, Wan Yee Lau; Final approval of manuscript: All authors.

Funding

This work was supported by the Key Project of the Natural Science Foundation of China (No: 81730097); grants from the Science Fund for Creative Research Groups (No: 81521091); the Chang Jiang Scholars Programme (2013) of China Ministry of Education; the National Key Basic Research Programme “973 project” (No: 2015CB554000); the National Natural Science Foundation of China (No: 81602523), Shanghai Municipal Health Bureau (No: SHDC12015106); and Shanghai Science and Technology Committee (No: 134119a0200).

DISCLOSURE

No potential conflicts of interest.

Supplementary material

10434_2019_7223_MOESM1_ESM.doc (1 mb)
Supplementary material 1 (DOC 1056 kb)

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Xiu-Ping Zhang
    • 1
  • Yan-Chen Liu
    • 1
    • 3
  • Zhen-Hua Chen
    • 1
  • Ju-Xian Sun
    • 1
  • Kang Wang
    • 1
  • Zong-Tao Chai
    • 1
  • Jie Shi
    • 1
  • Wei-Xing Guo
    • 1
  • Meng-Chao Wu
    • 1
  • Wan Yee Lau
    • 1
    • 2
  • Shu-Qun Cheng
    • 1
    Email author
  1. 1.Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghaiChina
  2. 2.Faculty of MedicineThe Chinese University of Hong KongShatinChina
  3. 3.Basic Medical CollegeSecond Military Medical UniversityShanghaiChina

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