Triple adjuvant therapy with transarterial chemoembolization, lenvatinib, and programmed death-1 inhibitors improves short-term recurrence control in high-risk patients with resected intermediate-stage hepatocellular carcinoma

作者：Guanhua Chen, Yiwen Qiu, Shu Shen, Jianchen Luo, Dongdong Zhu, Wentao Wang · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000004088 · 被引用次数：1 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Cancer Mechanisms and Therapy

BACKGROUND: Intermediate-stage hepatocellular carcinoma (HCC) following curative liver resection (LR) is associated with high recurrence rates and poor survival outcomes. Current studies have found that transarterial chemoembolization can improve overall survival rates and disease free survival in patients with intermediate-stage HCC after surgery. However, the benefits of this treatment are limited. This study aimed to evaluate the benefit of triple adjuvant therapy-transarterial chemoembolization (TACE) combined with antiangiogenic therapy (lenvatinib) plus programmed death-1 inhibitors (TAP)-as an adjuvant treatment for resected intermediate-stage HCC, compared to TACE alone, and to identify patient subgroups most likely to benefit from the TAP regimen. MATERIALS AND METHODS: We collected data of patients with intermediate-stage HCC who underwent LR from December 2019 to December 2022. Disease-free survival (DFS) was compared between patients receiving TACE and those receiving TAP using propensity score matching. The 2-year recurrence rate in the entire cohort was predicted based on the TACE group, and the association between the predicted and observed recurrences was tested. OUTCOMES: A total of 571 patients were included in our study, with 102 receiving TAP and 469 receiving TACE. Compared with TACE alone, TAP showed better DFS (HR: 0.74; 95% CI: 0.56-0.98; P = 0.037), with median: 22.0 months (95% CI: 19.0-24.0) vs 25.6 months (95% CI: 24.0-40.0). The lines for the TACE...