Adjuvant transarterial chemotherapy for margin-positive resection of hepatocellular carcinoma-a propensity score matched analysis.

Autor: Fok AJ; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., She WH; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. shewhbrian@gmail.com., Ma KW; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., Tsang SHY; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., Dai WC; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., Chan ACY; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., Lo CM; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China., Cheung TT; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2022 Feb; Vol. 407 (1), pp. 245-257. Date of Electronic Publication: 2021 Aug 18.
DOI: 10.1007/s00423-021-02292-9
Abstrakt: Background and Aims: Hepatectomy is a well-established curative treatment for hepatocellular carcinoma. However, the role of adjuvant therapy is controversial. This study examines the efficacy of adjuvant transarterial chemotherapy for hepatocellular carcinoma.
Methods: The data of hepatocellular carcinoma patients undergoing curative hepatectomy was reviewed. Those with adjuvant transarterial chemotherapy were matched with those without using propensity score analysis, by tumour size and number, indocyanine green retention rate, disease staging and Child-Pugh grading. The groups were compared.
Results: Eighty-seven patients with hepatocellular carcinoma who underwent hepatectomy received adjuvant transarterial chemotherapy (TAC group), and were matched with 870 patients who did not (no-TAC group). The groups were largely comparable in patient and disease characteristics, but the TAC group experienced more blood loss, higher transfusion rates, narrower margins and more positive margins. The two groups were found to be comparable in disease-free and overall survival rates. In margin-positive patients, those given TAC survived longer than those without, and margin-positive patients in the TAC group had overall survival rates similar to margin-negative patients in the no-TAC group.
Conclusions: Margin involvement is an adverse factor for survival in HCC. Adjuvant transarterial chemotherapy may offer survival benefits to hepatocellular carcinoma patients with positive surgical margins.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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