Comparative efficacy of postoperative transarterial chemoembolization with or without antiviral therapy for hepatitis B virus-related hepatocellular carcinoma
Comparative efficacy of postoperative transarterial chemoembolization with or without antiviral therapy for hepatitis B virus-related hepatocellular carcinoma
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DOI：
10.1007/s13277-015-3313-6
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发表时间：
2015-08-01
期刊：
影响因子：
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通讯作者：
Li, Le-Qun
中科院分区：
文献类型：
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作者：
Zhu, Shao-Liang;Zhong, Jian-Hong;Li, Le-Qun
本研究旨在探讨肝细胞癌（HCC）根治性切除术后辅助性肝动脉化疗栓塞（TACE）联合或不联合抗病毒治疗的疗效。本回顾性研究检查了176例根治性肝切除术后患者，其中118例单独使用TACE治疗，58例使用TACE联合抗病毒治疗。为了减少基线差异导致的混杂偏倚，使用倾向评分匹配从两个治疗组中生成51对患者。在倾向评分匹配前后分析两组的总生存期（OS）和无病生存期（DFS）。对所有患者的分析显示，联合治疗组的OS优于单纯TACE组（P = 0.048），而两组之间的DFS相似（P = 0.322）。仅倾向评分匹配对的分析证实联合治疗组的5年OS显著更好（64. 6 vs. 37. 5%，P = 0. 033），还表明5年DFS更好（37. 9 vs. 14. 6%，P = 0. 048）。在HCC复发患者中，联合治疗组中根治性手术是治疗选择的患者比例显著高于单纯TACE组（P = 0.018）。我们的研究结果表明，在肝细胞癌患者中，相对于单独的TACE，联合抗病毒治疗与TACE显著改善了OS和潜在的DFS。联合治疗似乎也使患者具有更大的残余肝功能，增加了复发时根治性切除的可能性。联合治疗可能有助于预防肝癌根治性切除术后复发。
This study aims to investigate the efficacy of adjuvant transarterial chemoembolization (TACE) with or without antiviral therapy for patients with hepatocellular carcinoma (HCC) after radical hepatectomy. This retrospective study examined 176 patients after radical hepatectomy, 118 of whom were treated using TACE alone and 58 using TACE combined with antiviral therapy. To reduce confounding bias due to baseline differences, propensity score matching was used to generate 51 pairs of patients from both treatment groups. Overall survival (OS) and disease-free survival (DFS) were analyzed for both groups before and after propensity score matching. Analysis of all patients showed that OS was better in the combination therapy group than in the TACE-only group (P = 0.048), while DFS was similar between the two groups (P = 0.322). Analysis of only propensity score-matched pairs confirmed the significantly better 5-year OS in the combination therapy group (64.6 vs. 37.5 %, P = 0.033) and also suggested better 5-year DFS (37.9 vs. 14.6 %, P = 0.048). Among patients experiencing HCC recurrence, radical surgery was the treatment choice for a significantly larger proportion of patients from the combination therapy group than from the TACE-only group (P = 0.018). Our results suggest that combining antiviral therapy with TACE significantly improves OS and potentially DFS relative to TACE alone in patients with HCC. Combination therapy also appears to leave patients with greater remnant liver function, increasing the possibility of curative resection in the event of recurrence. Combination therapy may be useful for preventing HCC recurrence after radical hepatectomy.