J Cancer 2019; 10(17):4063-4071. doi:10.7150/jca.29850 This issue

Research Paper

Comparison of macrovascular invasion-free survival in early-intermediate hepatocellular carcinoma after different interventions: A propensity score-based analysis

Yao Liu1*, Dongying Xue2*, Shanzhong Tan3*, Qun Zhang1, Xue Yang1, Yuxin Li1, Bingbing Zhu4, Shuaishuai Niu1, Li Jiang5✉, Xianbo Wang1✉

1. Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University. Beijing 100015, China.
2. Department of Infections Disease, Putuo Hospital, Shanghai University of Traditional Chinese Medicine. Shanghai 200062, China.
3. Department of Integrated TCM and Western Medicine, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China.
4. Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine. Beijing 100700, China.
5. Department of Surgery, Beijing Ditan Hospital, Capital Medical University. Beijing 100015, China.
*These authors contributed equally to this work.

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Citation:
Liu Y, Xue D, Tan S, Zhang Q, Yang X, Li Y, Zhu B, Niu S, Jiang L, Wang X. Comparison of macrovascular invasion-free survival in early-intermediate hepatocellular carcinoma after different interventions: A propensity score-based analysis. J Cancer 2019; 10(17):4063-4071. doi:10.7150/jca.29850. Available from https://www.jcancer.org/v10p4063.htm

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Abstract

Objectives: The purpose of this study was to compare macrovascular invasion (MVI)-free survival (MFS) at the three-year follow-up in patients with hepatocellular carcinoma (HCC) who underwent hepatic resection (HR), transcatheter arterial chemoembolization (TACE), or TACE combined with radiofrequency ablation (TACE-RFA).

Materials and Methods: We retrospectively analyzed the medical records of 828 patients who were diagnosed with Barcelona Clinic Liver Cancer (BCLC) stage A or stage B HCC. Of these patients, 116 underwent HR, 395 underwent TACE-RFA, 239 underwent TACE, and 78 patients received conservative treatment (control group). A validation cohort of 158 patients was included. The MFS and overall survival (OS) before and after propensity score (PS) matching were evaluated using Kaplan-Meier analysis.

Results: The baseline characteristics between the control and TACE groups were comparable. MFS was higher in the TACE group than in the control group at the three-year follow-up (p = 0.0091), and OS was similar in the two groups (p = 0.0549). PS matching was used to generate 68 pairs of patients in the control versus HR group and 74 pairs of patients in the control versus TACE-RFA group (1-to-1 matched). MFS was significantly higher in the HR or TACE-RFA groups than in the control group (p < 0.0001 (HR versus control) and p = 0.0001 (TACE-RFA versus control), respectively). Furthermore, for patients in the HR versus TACE-RFA versus TACE groups that were generated by PS matching, the Kaplan-Meier analysis showed that MFS and OS were higher with HR or TACE-RFA than with TACE at three years. In the study, similar results were obtained in the validation cohort.

Conclusions: MFS and OS were higher with HR or TACE-RFA than with TACE for HCC patients without MVI.

Keywords: Macroscopic vascular invasion, Hepatocellular carcinoma, Propensity score analysis