Adjuvant transarterial chemoembolization timing after radical resection is an independent prognostic factor for patients with hepatocellular carcinoma

Hongfa Sun; Hanlin Wang; Youpeng Wang; Wenqing Zhong; Yushan Meng; Ziqiang Lv; Weidong Guo; Bing Han

doi:10.3389/fonc.2023.1129065

Adjuvant transarterial chemoembolization timing after radical resection is an independent prognostic factor for patients with hepatocellular carcinoma

Front Oncol. 2023 Mar 9:13:1129065. doi: 10.3389/fonc.2023.1129065. eCollection 2023.

Authors

Hongfa Sun¹, Hanlin Wang¹, Youpeng Wang¹, Wenqing Zhong¹, Yushan Meng², Ziqiang Lv¹, Weidong Guo¹, Bing Han¹

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
² Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Abstract

Background: It has been reported that postoperative adjuvant TACE (PA-TACE) treatment decreases recurrence and significantly improves the survival of patients who undergo radical resection of hepatocellular carcinoma (HCC) with high-risk recurrence factors. However, when to perform PA-TACE has not been fully studied.

Methods: We retrospectively collected the clinicopathologic characteristics of the patients with HCC between October 2013 and June 2020. The optimal cutoff value for PA-TACE time was determined based on the R package "maxstat". Logistic regression and Cox regression analysis were used to determine the effect of the choice of PA-TACE timing on prognosis.

Results: The analysis was performed on 789 patients with HCC, and 484 patients were finally involved and were divided into training cohort (378) and validation cohort (106). The PA-TACE timing was found to be associated with survival outcomes. Multivariate logistic analysis found independent predictors of the PA-TACE timing, including gender and history of HBV. Multivariate Cox analysis showed that Ki-67, tumor size, MVI and the PA-TACE timing were independent prognostic factors for RFS in HCC patients.

Conclusions: Based on this study, HCC patients with high-risk recurrence factors can receive personalized assistance in undergoing PA-TACE treatment and improve their survival outcomes.

Keywords: HCC; TACE (transarterial chemoembolization); prognosis; timing; treatment.