Abstract
Purpose
This study aimed to assess the efficacy and safety of postoperative adjuvant transarterial
chemoembolization (PA-TACE) plus immune checkpoint inhibitor (ICI) for hepatocellular
carcinoma (HCC) with portal vein tumor thrombus (PVTT).
Patients and methods
This study was conducted on three centers from June 2018 to December 2020. Patients
were divided into the PA-TACE (n = 48) and PA-TACE plus ICI groups (n = 42). The recurrence-free
survival (RFS) and overall survival (OS) curves were depicted by Kaplan-Meier method,
and the differences between the two groups were compared using log-rank test. Univariate
and multivariate Cox analyses were performed to identify independent risk factors
for RFS and OS. Adverse events (AEs) were assessed according to the Common Terminology
Criteria for AEs (CTCAE) version 5.0.
Results
The median RFS of the PA-TACE plus ICI group was significantly longer than the PA-TACE
group (12.76 months vs. 8.11 months; P = 0.038). The median OS of the PA-TACE plus ICI group was also significanfly better
than the PA-TACE group (24.5 months vs. 19.1 months; P = 0.032). PA-TACE plus ICI treatment was an independent prognostic factor for RFS
(HR: 0.54, 95% CI: 0.32–0.9, P = 0.019) and OS (HR: 0.47, 95% CI: 0.26–0.86, P = 0.014). Only one patient experienced grade ≥3 immune-related AEs in the PA-TACE
plus ICI group.
Conclusions
PA-TACE plus ICI treatment had better efficacy in preventing recurrence and prolonging
survival than PA-TACE alone for HCC patients with PVTT after R0 resection. This novel
treatment modality may be an appropriate option for HCC with PVTT.
Keywords
Abbreviations:
ICI (immune checkpoint inhibitor), PA-TACE (postoperative adjuvant transarterial chemoembolization), PVTT (portal vein tumor thrombus), HCC (hepatocellular carcinoma), OS (overall survival), RFS (recurrence-free survival)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 17, 2023
Accepted:
January 16,
2023
Received in revised form:
January 9,
2023
Received:
October 10,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
