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. 2025 Aug 11:12:1767-1780.
doi: 10.2147/JHC.S534143. eCollection 2025.

Whether Adjuvant TACE Plus TKI Therapy is More Effective Than TACE Alone in HCC Patients at High Risks of Recurrence Following Radical Hepatectomy

Yaohua Li #  1 , Kai Wang #  2 , Huixia Qin #  3 , Shengjun Huo #  4 , Kaiwen Jiang #  1 , Jing Xia #  1 , Jing Gu  1 , Houxiang Ya  1 , Liya Suo  1 , Dejie Wang  5 , Xiaowang Huang  5 , Shuqun Li  1
Affiliations

Whether Adjuvant TACE Plus TKI Therapy is More Effective Than TACE Alone in HCC Patients at High Risks of Recurrence Following Radical Hepatectomy

Yaohua Li et al. J Hepatocell Carcinoma. .

Abstract

Purpose: To compare the efficacy and safety of postoperative adjuvant therapy with transarterial chemoembolization (TACE) plus tyrosine kinase inhibitor (TKI) (TPT) versus TACE alone in hepatocellular carcinoma (HCC) patients at high risks of recurrence after radical hepatectomy.

Patients and methods: We retrospectively analyzed 264 HCC patients who underwent radical hepatectomy (R0 resection) between August 2016 and August 2023. To mitigate selection bias, propensity score matching (PSM) was employed. The primary endpoints were recurrence-free survival (RFS) and overall survival (OS), analyzed using Kaplan-Meier curves and Log rank tests. Treatment-related adverse events (TRAEs) were graded according to CTCAE v4.0. Prognostic factors were evaluated via Cox proportional hazards regression.

Results: Before PSM, the cohort comprised 141 patients receiving TPT and 123 patients treated with TACE alone. After PSM, 81 well-balanced patients were selected per group (all p > 0.05). The TPT group exhibited significantly prolonged median recurrence-free survival (mRFS: 37.1 vs 27.7 months; p < 0.05) and median overall survival (mOS: 41.3 vs 38.3 months; p < 0.05) compared to the TACE alone group. The 1-, 2-, and 3-year RFS rates in the TPT group were 95.1%, 67.9%, and 48.1%, respectively, significantly higher than those in the TACE alone group (76.5%, 55.6%, and 40.7%; all p < 0.05). Similarly, the corresponding OS rates were 95.1%, 75.3%, and 54.3% (TPT) versus 81.5%, 66.7%, and 53.1% (TACE alone; all p < 0.05). Multivariable Cox regression analyses confirmed TPT as an independent protective factor for both RFS and OS. No significant increase in treatment-related adverse events (TRAEs) was observed with the TPT regimen compared to TACE alone. The overall TRAE rate was 51.8% in the TPT group, with grade ≥3 events occurring in 14.8% of patients, indicating an acceptable safety profile.

Keywords: adjuvant therapy; hepatocellular carcinoma; high risks of recurrence; radical hepatectomy; transarterial chemoembolization; tyrosine kinase inhibitors.

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Conflict of interest statement

The authors declare that there is no conflicts of interest in the research and publication of this article.

Figures

Figure 1
Figure 1
Flow chart of eligible patients enrolled.
Figure 2
Figure 2
Kapan-Meier curves of RFS and OS before PSM.
Figure 3
Figure 3
Kapan-Meier curves of RFS and OS after PSM.
Figure 4
Figure 4
The RFS curves of three TKIs drugs.
Figure 5
Figure 5
The OS curves of three TKIs drugs.
See this image and copyright information in PMC

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