Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study

Wu, Xiang'an; Wang, Yuxin; Wang, Sen; Chen, Ye; Han, Jiashu; Wang, Chao; Zhang, Meng; Hu, Xiongwei; Song, Biao; Wan, Xueshuai; Xu, Haifeng; Zhao, Haitao; Lu, Xin; Mao, Yilei; Sang, Xinting; Hong, Zhixian; Wei, Xiaoyong; Du, Shunda

doi:10.7150/jca.94539

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International Journal of Biological Sciences

International Journal of Medical Sciences

Theranostics

Journal of Genomics

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J Cancer 2024; 15(10):3024-3033. doi:10.7150/jca.94539 This issue Cite

Research Paper

Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study

Xiang'an Wu^1*, Yuxin Wang^1*, Sen Wang^3*, Ye Chen^4*, Jiashu Han², Chao Wang⁵, Meng Zhang⁵, Xiongwei Hu³, Biao Song³, Xueshuai Wan¹, Haifeng Xu¹, Haitao Zhao¹, Xin Lu¹, Yilei Mao¹, Xinting Sang¹, Zhixian Hong^3✉, Xiaoyong Wei^4✉, Shunda Du^1✉

1. Department of Liver Surgery, Peking Union Medical College Hospital, PUMC and Chinese Academy of Medical Sciences, Dongcheng, Beijing 100730, China.
2. 4+4 Medical Doctor Program, PUMC and Chinese Academy of Medical Sciences, Dongcheng, Beijing 100730, China.
3. Department of Hepatobiliary Surgery, the 302nd Hospital of Chinese PLA, Fengtai, Beijing, 100039, China.
4. Department of Hepatobiliary Surgery, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi, 330029, China.
5. Department of Hepatobiliary Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, China.
*Xiangan Wu, Yuxin Wang, Sen Wang and Ye Chen contributed equally to this manuscript.

✉ Corresponding authors: Shunda Du, M.D. Department of Liver Surgery, Peking Union Medical College Hospital, PUMC and Chinese Academy of Medical Sciences, Dongcheng, Beijing 100730, China; E-mail: dushdcn; Tel: 86-18612671763. Zhixian Hong, M.D More

Citation:

Wu X, Wang Y, Wang S, Chen Y, Han J, Wang C, Zhang M, Hu X, Song B, Wan X, Xu H, Zhao H, Lu X, Mao Y, Sang X, Hong Z, Wei X, Du S. Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study. J Cancer 2024; 15(10):3024-3033. doi:10.7150/jca.94539. https://www.jcancer.org/v15p3024.htm

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Abstract

Background: This study aimed to investigate the safety and efficacy of preoperative targeted immunotherapy followed by surgical resection for hepatocellular carcinoma (HCC) patients with macrovascular invasion.

Method: Clinical information of HCC patients with macrovascular invasion was collected from four medical centers. These patients were divided into two cohorts: the upfront surgery group (n=40) and the neoadjuvant group (n=22). Comparisons between the two groups were made with appropriate statistical methods.

Results: HCC Patients with macrovascular invasion in the neoadjuvant group were associated with increased incidence of postoperative ascites (72.73% vs. 37.5%, P=0.008), but shorter postoperative hospital stay (10 days vs. 14 days, P=0.032). Furthermore, targeted immunotherapy followed by surgical resection significantly reduced the postoperative recurrence rate at both 3 months and 1 year (9% versus 28.9%, 32.1% versus 67.9%, respectively; P=0.018), but increased the postoperative nononcologic mortality rate within 1 year (20.1% vs. 2.8%; P= 0.036).

Conclusion: For HCC patients with macrovascular invasion, preoperative targeted immunotherapy significantly decreased the postoperative tumor recurrence rate while maintaining relative safety, but such a treatment may also result in chronic liver damage and increased risk of nononcologic mortality.

Keywords: targeted immunotherapy, surgery, complications, the recurrence rate

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APA

Wu, X., Wang, Y., Wang, S., Chen, Y., Han, J., Wang, C., Zhang, M., Hu, X., Song, B., Wan, X., Xu, H., Zhao, H., Lu, X., Mao, Y., Sang, X., Hong, Z., Wei, X., Du, S. (2024). Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study. Journal of Cancer, 15(10), 3024-3033. https://doi.org/10.7150/jca.94539.

ACS

Wu, X.; Wang, Y.; Wang, S.; Chen, Y.; Han, J.; Wang, C.; Zhang, M.; Hu, X.; Song, B.; Wan, X.; Xu, H.; Zhao, H.; Lu, X.; Mao, Y.; Sang, X.; Hong, Z.; Wei, X.; Du, S. Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study. J. Cancer 2024, 15 (10), 3024-3033. DOI: 10.7150/jca.94539.

NLM

CSE

Wu X, Wang Y, Wang S, Chen Y, Han J, Wang C, Zhang M, Hu X, Song B, Wan X, Xu H, Zhao H, Lu X, Mao Y, Sang X, Hong Z, Wei X, Du S. 2024. Neoadjuvant targeted immunotherapy followed by surgical resection versus upfront surgery for hepatocellular carcinoma with macrovascular invasion: A multicenter study. J Cancer. 15(10):3024-3033.

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