Should transarterial chemoembolization be applied with systemic therapy for hepatocellular carcinoma with hepatic vein and/or inferior vena cava tumor thrombus (CHANCE2505)?: A multicenter study

作者：Long-Wang Lin, Qian Chen, Hong-Tao Hu, Guan‐Hui Zhou, Zhicheng Jin, Yun Zhou, Jian-Jia Chen, Jiansong Ji, Xiaoli Zhu, Ming Huang, Hai‐Bin Shi, Wei-Zhu Yang, Guohui Xu, Aibing Xu, Zhou-Chao Hu, Weidong Wang, Chang Zhao, Hai‐Dong Zhu · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000004144 · 被引用次数：1 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Venous Thromboembolism Diagnosis and Management

BACKGROUND: Systemic therapy with or without radiotherapy is useful for hepatocellular carcinoma (HCC) with hepatic vein and/or inferior vena cava tumor thrombus (HVTT/IVCTT). However, the efficacy of transarterial chemoembolization (TACE) in such population is still unconfirmed. This study aims to evaluate whether TACE should be applied with systemic therapy for HCC with HVTT/IVCTT, in a first-line therapy setting. METHODS: This multi-center retrospective cohort study included HCC patients with HVTT/IVCTT treated between June 2018 and March 2024. Patients received either systemic therapy plus TACE (Group A) or systemic therapy alone (Group B). Propensity score matching (PSM) was utilized to balance the baseline characteristics. Multiple sensitivity analysis including inverse probability of treatment weighting (IPTW) were performed. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included objective response rate (ORR) and safety. RESULTS: A total of 972 HCC patients with HVTT/IVCTT (696 in Group A and 276 in Group B) were included. The median follow-up time was 32.1 (95% CI: 30.4-33.8) months. After PSM, Group A demonstrated a significantly longer median OS compared to Group B (20.9 vs. 14.3 months; HR = 0.65, 95% CI: 0.54-0.77, P<0.001). Group A achieved a significantly longer median PFS compared to Group B (10.7 vs. 7.3 months; HR = 0.67, 95% CI: 0.57-0.79, P<0.001, per RECIST v1.1 criteria). Additionally, Group A exhi...