Repeated postoperative adjuvant TACE after curative hepatectomy improves outcomes of patients with HCC

Feng, Alei; Zhu, Jian; Yang, Yupeng; Wang, Ya Dong; Liu, Feng Yue; Zhu, Min; Liu, Chong Zhong

doi:10.1080/13645706.2019.1707689

“…Previous studies [ 24 , 25 ] have found that TACE treatment experience, liver cancer surgery or transplantation history, diabetes, chronic liver disease history, pain history, CRP level, ECOG score, preoperative anxiety, and postoperative TACE are risk factors for severe abdominal pain post-TACE. Severe abdominal pain post-TACE has a high incidence and has many influencing factors, so it is particularly important to actively prevent abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

Construction and Validation of Prediction Model of Severe Abdominal Pain Post-Transarterial Chemoembolization in Patients with HBV-Associated Primary Liver Cancer

Yang

¹

,

Chen

²

,

Yan

³

et al. 2022

Computational and Mathematical Methods in Medicine

1

0

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Objective. This study is aimed at constructing and evaluating a prediction model of severe abdominal pain post-transcatheter arterial chemoembolization in patients with HBV-related primary liver cancer. Methods. Patients with HBV-associated primary liver cancer who received transarterial chemoembolization (TACE) from March 2019 to March 2022 in the Interventional Therapy Department of our hospital were selected as the subjects, and the included 160 patients were randomly divided into modeling group ( n = 120 ) and validation group ( n = 40 ) in a ratio of 3 : 1. Visual analog scale (VAS) was used to assess pain severity. 120 patients in the modeling group were divided into no/mild abdominal pain group and severe abdominal pain group. The clinical data of the patients, including gender, age, TACE treatment history, vascular invasion, maximum diameter of tumor, infarction degree, preoperative Eastern Oncology Collaboration Group (ECOG) score, and Lipiodol dosage, were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the prediction model for severe abdominal pain post-TACE. Results. A total of 116 patients (72.50%) had severe abdominal pain after TACE. Univariate analysis showed that severe abdominal pain after TACE in the modeling group was associated with TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score (all P < 0.05 ), but not related to gender, age, vascular invasion, and Lipiodol dosage (all P > 0.05 ). Logistic regression analysis showed that TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score were all independent influencing factors for acute abdominal pain post-TACE in HBV-HCC patients (all P < 0.05 ). The prediction model equation was Y = − 3.673 + 1.722 × TACE treatment history + 1.175 × tumor maximum diameter + 2.064 × infarction degree + 1.555 × preoperative ECOG score . Goodness-of-fit test results showed no significant difference between the established prediction model and the observed value ( χ 2 = 1.645 , P = 0.560 ) and R 2 = 0.821 , suggesting that the prediction ability of the model was relatively accurate. ROC analysis results showed that the area under the curve (AUC) of severe abdominal pain after TACE was 0.916 (0.862~0.970) and 0.902 (95% CI: 0.841~0.963) in the modeling group and the verification group, respectively. Conclusion. TACE treatment history, tumor maximum diameter, infarction degree, and preoperative ECOG score are independent influencing factors for severe abdominal pain post-TACE in patients with HBV-HCC, and the prediction model established on this basis has good application value.

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“…Patients with large tumors or venous invasion are at higher risk of recurrence and are advised to receive TACE in clinical practice (23). Molecular analysis of in situ and recurrent tumors may improve our understanding of the mechanisms underlying recurrence and help identify prognostic biomarkers (24,25).…”

Section: Discussionmentioning

confidence: 99%

COCH predicts survival and adjuvant TACE response in patients with HCC

Wang

¹

,

Ding

²

,

Zheng

³

et al. 2021

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The aim of the present study was to measure the expression of Cochlin (COCH) and analyze its association with survival, recurrence and the benefits from adjuvant transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) following hepatectomy. Patients with high COCH expression levels had a poorer prognosis in terms of overall and disease-free survival rate compared with those with low COCH expression levels. Further analysis revealed that patients with low COCH expression who received TACE experienced markedly lower early recurrence rates compared with those who did not receive TACE. However, patients with high COCH expression with and without adjuvant TACE after resection experienced no difference in disease recurrence rates. The expression of COCH was found to be associated with hepatitis B virus infection, portal vein tumor thrombosis and Barcelona Clinic Liver Cancer stage in HCC. Therefore, the findings of the present study indicated that clinical detection of COCH expression may help estimate the prognosis of patients with HCC, as well as determine whether to administer TACE after surgery to prevent recurrence.

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“…Transcatheter arterial chemoembolization (TACE) is one of the main treatments for patients with advanced hepatocellular carcinoma (HCC), and is also widely recommended for the preoperative and postoperative treatment of patients undergoing radical hepatectomy (4). Several studies (5)(6)(7) have shown that postoperative adjuvant TACE (PA-TACE) can improve recurrence-free survival (RFS) and OS, and can significantly improve the prognosis of HCC patients. However, the indicators used to identify the postoperative liver cancer patients likely to benefit from PA-TACE are limited, and the indications for PA-TACE differ among medical centers.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effect of postoperative adjuvant transcatheter arterial chemoembolization based on the neutrophil-to-lymphocyte ratio

Feng

¹

,

Shi²,

Zhao³

et al. 2023

Front. Surg.

0

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AimTo evaluate the feasibility of the preoperative neutrophil-to-lymphocyte ratio (NLR) as an index to guide postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with liver cancer.MethodsWe recruited a total of 166 patients with liver cancer who underwent surgery alone or surgery plus PA-TACE between January 2013 and June 2017 and compared the 1, 2, and 3-year recurrence-free survival (RFS) and overall survival (OS) between patients with high and low NLRs, surgery and surgery plus PA-TACE groups, and relevant subgroups using the Kaplan–Meier method. We also evaluated the independent factors affecting the prognosis of liver cancer after surgery using a Cox risk ratio model and correlation between NLR levels and high-risk recurrence factors of liver cancer with logistic regression analysis.ResultsThe 1, 2, and 3-year RFS rates were all significantly higher in the low-NLR group compared to the high-NLR group (P < 0.05). However, the 1, 2, and 3-year OS rates were similar in the low- and high-NLR groups (P > 0.05). After propensity score matching, the 1, 2, and 3-year RFS and OS rates were significantly better in patients treated with surgery plus PA-TACE compared with surgery alone (P < 0.05). The 1, 2, and 3-year RFS and OS rates were also significantly better in the surgery plus PA-TACE subgroup compared with the surgery-alone subgroup in the high-NLR group (P < 0.05), but there was no significant difference in RFS or OS between the surgery plus PA-TACE and surgery-alone subgroups at 1, 2, and 3 years in the low-NLR group (P > 0.05). Multivariate analysis in the high-NLR group showed that a poorly differentiated or undifferentiated tumor was an independent risk factor for postoperative RFS. Multiple tumors were an independent risk factor for postoperative OS (P < 0.05), while PA-TACE was an independent protective factor for postoperative RFS and OS (P < 0.05). In the low-NLR group, AFP > 400 µg/L was an independent risk factor for postoperative OS (P < 0.05). Multivariate logistic regression indicated that patients with a maximum tumor diameter of >5 cm were at increased risk of having high NLR levels compared to patients with a maximum tumor diameter of <5 cm (P < 0.05).ConclusionPA-TACE can improve the prognosis of patients with a high preoperative NLR (≥2.5), but has no obvious benefit in patients with low preoperative NLR (<2.5). This may provide a reference for clinical selection of PA-TACE.

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Repeated postoperative adjuvant TACE after curative hepatectomy improves outcomes of patients with HCC

Cited by 14 publications

References 33 publications

Construction and Validation of Prediction Model of Severe Abdominal Pain Post-Transarterial Chemoembolization in Patients with HBV-Associated Primary Liver Cancer

Construction and Validation of Prediction Model of Severe Abdominal Pain Post-Transarterial Chemoembolization in Patients with HBV-Associated Primary Liver Cancer

COCH predicts survival and adjuvant TACE response in patients with HCC

Therapeutic effect of postoperative adjuvant transcatheter arterial chemoembolization based on the neutrophil-to-lymphocyte ratio

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