Adjuvant Transarterial Chemoembolization for HBV-Related Hepatocellular Carcinoma After Resection: A Randomized Controlled Study

Wang, Zheng; Ren, Zhigang; Chen, Yi; Hu, Jie; Yang, Guo‐Huan; Yu, Lei; Yang, Xin‐Rong; Huang, Ao; Zhang, Xin; Zhou, Shao-Lai; Sun, Hui‐Chuan; Wang, Yanhong; Ge, Ning; Xu, Xiaoyu; Tang, Zhao–You; Lau, W. Y.; Fan, Jia; Wang, Jiping; Zhou, Jian

doi:10.1158/1078-0432.ccr-17-2899

Cited by 216 publications

(234 citation statements)

References 30 publications

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“…Nevertheless, little is known about the mechanism of HCC metastasis. Currently, transcatheter arterial chemoembolization is the only effective adjuvant therapy with global acceptance to prevent recurrence of HCC after curative resection, but its efficiency is limited . Thus, it is necessary to find key molecules associated with HCC invasion, which might be potential therapeutic targets for HCC.…”

Section: Introductionmentioning

confidence: 99%

Glutamine synthetase promotes tumor invasion in hepatocellular carcinoma through mediating epithelial–mesenchymal transition

Liu

Al-Ameri

et al. 2020

Hepatology Research

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Aim Glutamine synthetase (GS) levels increase gradually with the development of hepatocellular carcinogenesis. In this study, we aimed to investigate the clinical significance of GS and the underlying mechanism of GS promoting hepatocellular carcinoma (HCC) invasion. Methods Serum concentration of GS and α‐fetoprotein (AFP) in HCC patients, liver cirrhosis patients, and healthy individuals were detected. The GS‐mRNA level and its prognostic value were explored in an independent HCC cohort from The Cancer Genome Atlas database. GS expression in HCC tissue and matched para‐tumor tissue was determined. The effect of GS on HCC invasion was assessed in vitro and in vivo. Results The serum GS and AFP level in HCC patients was higher than that in healthy controls and liver cirrhosis patients. The area under the receiver operating characteristic curve for HCC diagnosis was 0.848 and 0.861 for GS and AFP, respectively. The area under the receiver operating characteristic curve of GS for diagnosis of AFP‐negative HCC was 0.913. Combining GS with AFP achieved a diagnostic sensitivity and specificity of 82.5% and 93%, respectively. The GS level was higher in tumor tissues than that in para‐tumor tissues. High GS expression was associated with poor prognosis of moderately differentiated HCC patients. In vitro, GS exerted an influence on HCC cell migration by mediating epithelial–mesenchymal transition. The lung and liver metastatic model of HCC further confirmed that GS expression affected the invasion of HCC cells in vivo. Conclusions GS is a useful biomarker for HCC diagnosis, especially for AFP‐negative patients. In addition, GS affects HCC metastasis through mediating epithelial–mesenchymal transition.

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Section: Introductionmentioning

confidence: 99%

Glutamine synthetase promotes tumor invasion in hepatocellular carcinoma through mediating epithelial–mesenchymal transition

Liu

Al-Ameri

et al. 2020

Hepatology Research

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“…In our previous retrospective study, postoperative adjuvant TACE prolonged the survival of patients with risk factors [28,29]. In our prospective study, we found that adjuvant TACE significantly reduced tumour recurrence and improved RFS and OS in patients with HBV-related HCC who had an intermediate or high risk for recurrence [16]. Regarding ICC recurrence, ICC patients with high nomogram scores benefited from adjuvant TACE following liver resection [30].…”

Section: The Prognostic Factors Of Chc After Psmmentioning

confidence: 74%

“…Similar to HCC and ICC, for CHC, recurrence is the most adverse factor influencing OS and DFS; vascular and lymph node invasion as well as the presence of satellite metastasis have been suggested as significant predictors of poor outcome after curative resection [13][14][15]. Transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA) are the most widely used treatments for HCC and postresection recurrence [16][17][18]. For CHC, TACE shows an advantageous response and prognosis in recurrent patients after resection [19].…”

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confidence: 99%

Adjuvant Transarterial Chemoembolization does not Influence Recurrence-free and Overall survivals for Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma after Curative Resection: a Propensity Score Matching Analysis

Liu

Tian

Tao

et al. 2020

Preprint

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KEYWORDSombined hepatocellular carcinoma and intrahepatic cholangiocarcinoma; transarterial chemoembolization; overall survival; disease-free survival; propensity score matching analysis 3 Abstract Background : The prognosis of patients with combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma (CHC) is usually poor, and effective adjuvant therapy is ineffective making it important to investigate whether these patients may benefit from adjuvant transarterial chemoembolization (TACE). We aimed to evaluate the efficiency of adjuvant TACE for long-term recurrence and survival after curative resection before and after propensity score matching (PSM) analysis. Methods : In this retrospective study, of 230 patients who underwent resection for CHC between January 1994 and December 2014, 46 (18.0%) patients received adjuvant TACE. Univariate and multivariate regression analyses were used to identify the independent predictive factors of survival. Cox regression analyses and log-rank tests were used to compare overall survival (OS) and disease-free survival (DFS) between patients who did or did not receive adjuvant TACE. Results : A total of 230 patients (mean age 52.2±11.9 years; 172 men) were enrolled, and 46 (mean age 52.7±11.1 years; 38 men) patients received TACE. Before PSM, in multivariate regression analysis, γglutamyl transpeptidase (γ-GT), tumour nodularity, macrovascular invasion (MVI), lymphoid metastasis, and extrahepatic metastasis were associated with OS. Alanine aminotransferase (ALT), MVI, lymphoid metastasis, and preventive TACE (HR: 2.763, 95% CI: 1.769-4.314, p <0.001) were independent prognostic factors for DFS. PSM created 46 pairs of patients. After PSM, adjuvant preventive TACE was not associated with an increased risk of OS (HR: 0.911, 95% CI: 0.545-1.520, p =0.720) or DFS (HR: 3.345, 95% CI: 1.686-6.638, p =0.001). After PSM, the 5-year OS and DFS rates were comparable in the TACE group and the non-TACE group (OS: 22.7% vs 14.9%, respectively, p =0.75; DFS: 11.2% vs 14.4%, respectively, p =0.06). Conclusions : The present study identified that adjuvant preventive TACE did not influence DFS or OS after curative resection of CHC. BackgroundPrimary liver cancer (PLC) is a heavy global health burden; it ranks as the second leading cause of mortality in men in less-developed countries, especially in China, which accounts for more than 50%of PLC patients in the world [1,2]. PLC is composed of several biologically distinct subtypes:hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular-

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“…Those patients with type III PVTT, multiple tumors, or cirrhosis were likely to derive more clinical benefit than their counterparts, indicating that PVC could reduce the risks of recurrence and death in patients with unfavorable clinicopathological factors. 18,23 Furthermore, a high HBV DNA level adversely affected survival, likely due to impaired hepatic function. Consequently, use of antiviral treatment is advisable at levels >10 4 IU/mL during PVC administration.…”

Section: Discussionmentioning

confidence: 99%

“…Since sex, age, degree of PVTT, Edmondson stage, tumor number, tumor encapsulation, tumor size, AFP level, HCV, HBsAg, HBV DNA, AST, GGT, albumin, platelet count, PT, degree of cirrhosis, and Child-Pugh stage were potential prognostic factors for HCC patients, they were taken into consideration in the PSM analysis 23,24. To further investi-…”

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confidence: 99%

Chemotherapeutic perfusion of portal vein after tumor thrombectomy and hepatectomy benefits patients with advanced hepatocellular carcinoma: A propensity score‐matched survival analysis

et al. 2019

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Background Portal vein tumor thrombus (PVTT) is a common complication in hepatocellular carcinoma (HCC), signaling dismal outcomes. This study was conducted to evaluate the survival benefit of postoperative portal vein perfusion chemotherapy (PVC) in patients with HCC and PVTT. Methods A retrospective review was conducted in 401 consecutive patients with HCC and PVTT who underwent hepatic resection between January 2009 and December 2015 and 67 patients received adjuvant postoperative PVC. A propensity score matching (PSM) was used to match patients with and without PVC at a ratio of 1:1. Results After PSM, the median time to recurrence (TTR) and overall survival (OS) were significantly longer in PVC group compared with control group (12.3 vs 5.8 months, P = .001; 19.0 vs 13.4 months, P = .037; respectively). At 1, 2, 3, and 5 years, the cumulative recurrence rates in PVC group were 48.1%, 86.5%, 92.3% ,96.2%, respectively, with OS rates of 63.8%, 37.9%, 24.4%, 18.3%, respectively; whereas cumulative recurrence rates of 76.6%, 91.5%, 94.3%, and 97.2%, respectively and OS rates of 55.4%, 23.0%, 12.4%, and 12.4%, respectively were recorded for the control group. In multivariate analysis, postoperative PVC emerged as a significant predictor for TTR (hazard ratio [HR], 0.523; P = .001) and OS (HR, 0.591; P = .010). PVC could reduce early recurrence (≤1 year) rate after surgical resection (40.3% vs 64.2%, P = .006) and clinical outcomes were further enhanced by adding sorafenib to postoperative PVC. Conclusions Compared with surgical resection alone, postoperative adjuvant PVC treatment boosts survival and reduces early tumor recurrences in patients surgically treated for HCC and PVTT.

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Adjuvant Transarterial Chemoembolization for HBV-Related Hepatocellular Carcinoma After Resection: A Randomized Controlled Study

Cited by 216 publications

References 30 publications

Glutamine synthetase promotes tumor invasion in hepatocellular carcinoma through mediating epithelial–mesenchymal transition

Glutamine synthetase promotes tumor invasion in hepatocellular carcinoma through mediating epithelial–mesenchymal transition

Adjuvant Transarterial Chemoembolization does not Influence Recurrence-free and Overall survivals for Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma after Curative Resection: a Propensity Score Matching Analysis

Chemotherapeutic perfusion of portal vein after tumor thrombectomy and hepatectomy benefits patients with advanced hepatocellular carcinoma: A propensity score‐matched survival analysis

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