Transcatheter arterial infusion chemotherapy with cisplatin in combination with transcatheter arterial chemoembolization decreases intrahepatic distant recurrence of unresectable hepatocellular carcinoma

Abstract

Background and Aim: This study investigated the efficacy of transcatheter arterial infusion (TAI) chemotherapy with cisplatin combined with transcatheter arterial chemoembolization (TACE). The goal was to prevent intrahepatic distant recurrence (IDR) of hepatocellular carcinoma (HCC), compared with TACE alone, in patients with unresectable HCC. Methods: We conducted a historical cohort study, which involved 68 unresectable HCC patients. The study was performed on 44 and 24 consecutive patients who underwent TAI using cisplatin combined with TACE using epirubicin and TACE using epirubicin alone, respectively. We performed a propensity score analysis to identify the independent risk factors associated with IDR, and constructed propensity score-adjusted survival curves. Results: After propensity score-adjusting, the adjusted cumulative IDR rates at 1 and 3 years were 76.8 and 76.8% in TACE alone group, and 21.3 and 73.1% in TACE with TAI group, respectively. TACE alone group had a significantly higher IDR rate in comparison with TACE with TAI group (P = 0.0073). Combined with TAI was associated with preventing IDR after propensity score-adjusting (hazard ratio [HR] 0.40, 95% confidence intervals [CI] 0.17-0.91, P = 0.028). Combined with TAI (HR 0.26, 95% CI 0.10-0.68, P = 0.0056) and Stage ≥III (HR 2.98, 95% CI 1.25-7.12, P = 0.014) were independent IDR predictors after adjusting for significant risk factors with propensity score. Conclusions: We demonstrated that cisplatin TAI accompanied with TACE decreased IDR compared with TACE alone. Our findings suggest that cisplatin TAI might contribute to a longer progression-free period in unresectable HCC patients treated with TACE.

Hepatic Arterial Infusion Chemotherapy vs Transcatheter Arterial Chemoembolization as Adjuvant Therapy Following Surgery for MVI-Positive Hepatocellular Carcinoma: A Multicenter Propensity Score Matching Analysis

“…Similar to our study’s conclusion, Kawabe et al demonstrated that HAIC is superior to TACE alone in reducing the incidence of intrahepatic metastasis in unresectable HCC patients. 51 These findings suggest that a-HAIC provides better control over residual, minuscule, and imperceptible lesions that could potentially become recurrent foci in the future.…”

HAIC versus TACE for patients with unresectable hepatocellular carcinoma: A systematic review and meta-analysis

“…Importantly, HAIC has been reported to be effective in reducing the incidence of intrahepatic metastasis in these patients. [ 35 ] A randomized phase III study showed a significant difference in the surgical conversion rate between the 2 groups ( P < .004). [ 36 ] In Asia, especially in Japan and South Korea, HAIC has been used as a method to improve the prognosis of advanced HCC and has been included in treatment guidelines.…”

Drug-Eluting Bead Transarterial Chemoembolization Combined with FOLFOX-Based Hepatic Arterial Infusion Chemotherapy for Large or Huge Hepatocellular Carcinoma

“…Intrahepatic metastasis occurs more often in HCC patients with a non-smooth margin or macrovascular invasion 33 and HAIC was reported to effectively decrease the occurrence of intrahepatic metastasis in these patients. 34 This might be an important reason why D-TACE-HAIC could improve the outcomes in patients with a non-smooth tumor margin or macrovascular invasion. By contrast, in HCC with a smooth tumor margin, D-TACE-HAIC and DEB-TACE led to a similar median OS (37.0 vs 35.0 months), consistent with the median OS of 33.4–35.6 months for large non-infiltrative HCC undergoing DEB-TACE in previous studies.…”