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. 2021 May 21;100(20):e25749.
doi: 10.1097/MD.0000000000025749.

Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma: A propensity score matching analysis

He Linye  1 , Xia Zijing  2 , Peng Wei  3 , He Chao  3 , Li Chuan  3 , Wen Tianfu  3
Affiliations

Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma: A propensity score matching analysis

He Linye et al. Medicine (Baltimore). .

Abstract

Thymosin alpha-1 (Tα1) is an immunomodulatory and antiviral agent with potential effects on chronic hepatitis B and liver cancer. Its impact on solitary hepatocellular carcinoma (HCC) remains controversial, so we aimed to investigate the efficacy of Tα1 in solitary HBV-related HCC patients after curative resection.Between May 2010 and April 2016, 468 patients with solitary HBV-related HCC after curative resection were analyzed. Propensity score matching (PSM) was used to minimize confounding variables. Risk factors were identified by the Cox proportional hazards model. Recurrence-free survival (RFS) rates, overall survival (OS) rates, immunological, and virologic response were compared.The median follow up was 60.0 months. Immunological response improved in the Tα1 group compared with the control group (P < .001) but the virologic response was similar between 2 groups after 24 months. Patients with Tα1 therapy had better RFS and OS before (P = .018 and P < .001) and after (P = .006 and P < .001) propensity matching. Multivariate analysis revealed that Tα1 therapy was an independent prognostic factor for both OS (P < .001, HR = 0.308, 95% CI: 0.175-0.541) and RFS (P < .001, HR = 0.381, 95% CI: 0.229-0.633).Tα1 as an adjuvant therapy improves the prognosis of solitary HBV-related HCC patients after curative liver resection.

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Conflict of interest statement

The authors have no conflicts of interests to declare.

Figures

Figure 1
Figure 1
Minimized difference between Tα1 and control group after propensity score matching. A, Lineplot of standardized differences before and after matching; B, Even distribution of propensity score in matched patients.
Figure 2
Figure 2
Survival curves of the control groups and Tα1 groups in the entire cohort and propensity matched cohort. (A-B) Overall survival and Recurrence-free survival of control group and Tα1 group in the entire cohort. (C-D) Overall survival and Recurrence-free survival of control group and Tα1 group in the propensity matched cohort.
Figure 3
Figure 3
Dynamic NLR changes of patients after radical hepatectomy in 1 year follow-up in the entire cohort (A) and propensity matched cohort (B). NLR = neutrophil to lymphocyte ratio, Tα1 = thymosin alpha-1.
Figure 4
Figure 4
Viral response, HBeAg seroconversion in control and Tα1 group. (A-B) HBeAg loss and HBeAg seroconversion rate in entire and propensity matched cohort; (C-D) HBV-DNA undetectable rate in entire and propensity matched cohort (∗∗∗P < .0001). HbeAg = Hepatitis B surface antigen.
See this image and copyright information in PMC

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