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. 2021 Jun 4:11:662408.
doi: 10.3389/fonc.2021.662408. eCollection 2021.

Transarterial Chemoembolization in Treatment-Naïve and Recurrent Hepatocellular Carcinoma: A Propensity-Matched Outcome and Risk Signature Analysis

Yiming Liu  1   2 , Yanqiao Ren  1   2 , Sangluobu Ge  1   2 , Bin Xiong  1   2 , Guofeng Zhou  1   2 , Gansheng Feng  1   2 , Songlin Song  1   2 , Chuansheng Zheng  1   2
Affiliations

Transarterial Chemoembolization in Treatment-Naïve and Recurrent Hepatocellular Carcinoma: A Propensity-Matched Outcome and Risk Signature Analysis

Yiming Liu et al. Front Oncol. .

Abstract

Objectives: The purpose of this study was to evaluate the efficacy and safety of transarterial chemoembolization (TACE) in the treatment of patients with treatment-naïve hepatocellular carcinoma (TN-HCC) and recurrent HCC (R-HCC). In addition, risk signature analysis was performed to accurately assess patients' recurrence and survival.

Methods: This retrospective study assessed the consecutive medical records of TN-HCC and R-HCC patients from January 2014 to December 2018. In order to reduce the patient selection bias, propensity score matching (PSM) analysis was applied. Conditional inference tree was used to establish a risk signature.

Results: A total of 401 eligible patients were included in our study, including 346 patients in the TN-HCC group and 55 patients in the R-HCC group. Forty-seven pairs of patients were chosen after the PSM analysis. Before the PSM analysis, the objective tumor regression (ORR) and disease control rate (DCR) of R-HCC patients were better than that of TN-HCC patients; however, after the PSM analysis, there was no significant difference in the ORR and DCR between the two groups (P>0.05). Before the PSM analysis, the median overall survival (OS) and progression-free survival (PFS) in the R-HCC group were significantly greater than those of the TN-HCC group (OS: 24 months vs. 18 months, P =0.004; PFS: 9 months vs. 6 months, P =0.012). However, after the PSM analysis, the median OS and PFS in the R-HCC group were inferior to those in the TN-HCC group (OS: 24 months vs. 33 months, P= 0.0035; PFS: 10 months vs. 12 months, P = 0.01). The conditional inference tree divided patients into different subgroups according to tumor size, BCLC stage, and TACE sessions and shared different hazards ratio to recurrence or survival.

Conclusion: Patients with R-HCC treated with TACE achieved satisfactory results, although survival after the PSM analysis was not as good as in the TN-HCC group. In addition, risk signature based on conditional inference tree analysis can more accurately predict the recurrence and survival in both groups of patients.

Keywords: hepatocellular carcinoma; liver resection; propensity score matching; recurrence; transarterial chemoembolization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart shows the screening procedure for patients with recurrent HCC after liver resection and treatment-naïve HCC.
Figure 2
Figure 2
Kaplan-Meier curves of cumulative survival (A) and progression-free survival (PFS) (B) in patients with recurrent HCC after liver resection and treatment-naïve HCC before propensity score matching.
Figure 3
Figure 3
Kaplan-Meier curves of cumulative survival (A) and progression-free survival (PFS) (B) in patients with recurrent HCC after liver resection and treatment-naïve HCC after propensity score matching.
Figure 4
Figure 4
Prediction of progression-free survival (PFS) (A) and Kaplan-Meier curves of PFS (B) based on decision tree results.
Figure 5
Figure 5
Prediction of overall survival (OS) (A) and Kaplan-Meier curves of OS (B) based on decision tree results.
See this image and copyright information in PMC

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References

    1. European Association for the Study of the Liver . EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma. J Hepatol (2018) 69:182–236. 10.1016/j.jhep.2018.03.019 - DOI - PubMed
    1. Llovet JM, Real MI, Montana X, Planas R, Coll S, Aponte J, et al. . Arterial Embolisation or Chemoembolisation Versus Symptomatic Treatment in Patients With Unresectable Hepatocellular Carcinoma: A Randomised Controlled Trial. Lancet (2002) 359:1734–39. 10.1016/S0140-6736(02)08649-X - DOI - PubMed
    1. Llovet JM, Bruix J. Systematic Review of Randomized Trials for Unresectable Hepatocellular Carcinoma: Chemoembolization Improves Survival. Hepatology (2003) 37:429–42. 10.1053/jhep.2003.50047 - DOI - PubMed
    1. Maluccio M, Covey A. Recent Progress in Understanding, Diagnosing, and Treating Hepatocellular Carcinoma. CA Cancer J Clin (2012) 62:394–9. 10.3322/caac.21161 - DOI - PubMed
    1. Jeon MY, Kim HS, Lim TS, Han DH, Kim BK, Park JY, et al. . Refractoriness to Transarterial Chemoembolization in Patients With Recurrent Hepatocellular Carcinoma After Curative Resection. PloS One (2019) 14:e0214613. 10.1371/journal.pone.0214613 - DOI - PMC - PubMed