Tumor Size Affects Efficacy of Adjuvant Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma and Microvascular Invasion
Tumor Size Affects Efficacy of Adjuvant Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma and Microvascular Invasion
复制标题
肿瘤大小影响肝细胞癌合并微血管侵犯患者辅助经动脉化疗栓塞的疗效
DOI：
10.1634/theoncologist.2018-0305
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发表时间：
2019-04-01
期刊：
影响因子：
5.8
通讯作者：
Ye, Qinghai
中科院分区：
文献类型：
--
作者：
Liu, Shuang;Li, Hui;Ye, Qinghai
BackgroundPatients with hepatocellular carcinoma（HCC）and microvascular invasion（mVI）have shown despite postoperative prognosis; however，according to adjuvant transarterial chemoembolization（TACE）can improve their outcomes.Materials and MethodsWe retrospectively identified 549 eligible patients to form the crude cohort and adopted propensity score matching method to assemble another cohort of 444 patients with similar baseline characteristics.我们评估了分层分析和多变量考克斯分析在两个cohols.ResultsThere辅助TACE的效果肿瘤大小和辅助TACE的总生存率（OS; P = 0.006的相互作用）之间有显着的相互作用。在匹配队列中，接受辅助TACE的患者显示出更高的5年OS率（72.4% vs. 50.9%，p = .005）和5年无复发生存率在肿瘤5 cm亚组中（50.5%对36.4%，p = .003），但在肿瘤>5 cm亚组中没有（32.3%对24.9%，p = .350和18.8%对19.7%，p = .180）。在肿瘤<5 cm的患者中观察到辅助TACE对OS的独立保护作用（校正比值比[OR] = 0.59，95%置信区间[CI] 0.36-0.97），但在肿瘤>5 cm的患者中未观察到辅助TACE对OS的独立保护作用（校正OR = 1.17，95% CI 0.84-1.62）。辅助TACE的效果并没有实质性的变化，而在原油cohol.ConclusionFor HCC和mVI患者的分析进行，辅助TACE与改善的结果，但不为那些肿瘤>5厘米，根据目前的协议。
BackgroundPatients with hepatocellular carcinoma (HCC) and microvascular invasion (mVI) have shown dismal postoperative prognosis; however, whether adjuvant transarterial chemoembolization (TACE) can improve their outcomes remains unclear.Materials and MethodsWe retrospectively identified 549 eligible patients to form the crude cohort and adopted propensity score matching method to assemble another cohort of 444 patients with similar baseline characteristics. We assessed the effects of adjuvant TACE by stratified analyses and multivariate Cox analyses in two cohorts.ResultsThere was significant interaction between tumor size and adjuvant TACE with respect to overall survival (OS; p = .006 for interaction). In the matched cohort, patients who received adjuvant TACE showed higher rates of 5-year OS (72.4% vs. 50.9%, p = .005) and 5-year recurrence-free survival (50.5% vs. 36.4%, p = .003) in the tumor 5 cm subgroup, but not in the tumor >5 cm subgroup (32.3% vs. 24.9%, p = .350 and 18.8% vs. 19.7%, p = .180). The independent protective role of adjuvant TACE on OS was observed in patients with tumor 5 cm (adjusted odds ratio [OR] = 0.59, 95% confidence interval [CI] 0.36-0.97) but not in patients with tumor >5 cm (adjusted OR = 1.17, 95% CI 0.84-1.62). The effects of adjuvant TACE did not change materially while the analysis was performed in the crude cohort.ConclusionFor patients with HCC and mVI, adjuvant TACE was associated with improved outcomes, but not for those with tumor >5 cm, according to the current protocol.