Adjuvant transarterial chemoembolization for intermediate-stage hepatocellular carcinoma with microvascular invasion

作者：Xiaohui Wang, Qunfang Zhou, Chen-Meng Wang, Cai‐Ling Xiang, Yinghui Song, Shaoqiang Li, Minshan Chen, Shuanglin Xiang, Changjun Liu, Xianhai Mao · 发表于：British journal of surgery · 年份：2022 · DOI：10.1093/bjs/znac376 · 被引用次数：12 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Hepatitis B Virus Studies、Cholangiocarcinoma and Gallbladder Cancer Studies

With improvements in surgical technique and perioperative care, liver resection (LR) has proven to be an effective option for certain patients with intermediate-stage hepatocellular carcinoma (HCC)1,2. Higher rates of tumour recurrence after curative LR lead to reduced overall survival (OS) in patients with intermediate-stage HCC, in particular those with tumours demonstrating microvascular invasion (MVI)3. It is important to find effective therapies for these patients. Currently, the main adjuvant therapy for the prevention of postoperative recurrence in patients with early-stage HCC with MVI is transarterial chemoembolization (TACE)4,5. Whether or not adjuvant TACE reduces recurrence and prolongs survival of patients with MVI-positive tumours remains controversial. The aim of this study was to investigate whether adjuvant TACE effectively reduced recurrence and prolonged survival of patients with intermediate-stage HCC with MVI. This was a multicentre retrospective study undertaken in four centres in China. Data from consecutive patients diagnosed with intermediate-stage HCC (Barcelona Clinic Liver Cancer stage B) who had undergone curative LR between January 2014 and December 2018, and had MVI-positive tumours diagnosed at pathology, were collected. Inclusion criteria were: age 18–80 years, curative LR, absence of macrovascular invasion, no preoperative anticancer treatments, Child–Pugh grade A or B, and no history of other malignancies. Patients with poor tumour different...