Systemic chemotherapy improves outcome of hepatocellular carcinoma patients treated with transarterial chemoembolization  

作　　者：Wei-Chen Zhang Ke-Yi Du Song-Feng Yu Xue-E Guo Han-Xi Yu Dong-Yan Wu Cheng Pan Cheng Zhang Jian Wu Li-Fang Bian Lin-Ping Cao Jun Yu 

机构地区：[1]Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China [2]Zhejiang University School of Medicine,Hangzhou 310000,China [3]Department of Nursing,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China [4]International Institutes of Medicine,Fourth Affiliated Hospital,Zhejiang University School of Medicine,Yiwu 322000,China [5]The 903rd Hospital of PLA,Hangzhou 310000,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》2025年第2期157-163,共7页国际肝胆胰疾病杂志(英文版)

基　　金：supported by grants from the National Natural Science Foundation of China(82270682);the Natural Science Foundation of Zhejiang Province(LQ21H030007 and LQ20H30006)。

摘　　要：Background:Transarterial chemoembolization(TACE)based neoadjuvant therapy was proven effective in hepatocellular carcinoma(HCC).Recently,tyrosine kinase inhibitors(TKIs)and immune checkpoint inhibitors(ICIs)also showed promise in HCC treatment.However,the prognostic benefits associated with these treatments remain uncertain.This study aimed to explore the relationship between pathologic response and prognostic features in HCC patients who received neoadjuvant therapy.Methods:HCC patients who received TACE either with or without TKIs/ICIs as neoadjuvant therapy before liver resection were retrospectively collected from the First Affiliated Hospital,Zhejiang University School of Medicine in China.Pathologic response was determined by calculating the proportion of non-viable area within the tumor.Major pathologic response(MPR)was defined as the presence of non-viable tumor cells reaching a minimum of 90%.Complete pathologic response(CPR)was characterized by the absence of viable cells observed in the tumor.Results:A total of 481 patients meeting the inclusion criteria were enrolled,with 76 patients(15.8%)achieving CPR and 179(37.2%)reaching MPR.The median recurrence-free survival(m RFS)in the CPR+MPR group was significantly higher than the non-MPR group(31.3 vs.25.1 months).The difference in 3-year overall survival(OS)rate was not significant.Multivariate Cox regression analysis identified failure to achieve MPR(hazard ratio=1.548,95%confidence interval:1.122–2.134;P=0.008),HBs Ag positivity(HR=1.818,95%CI:1.062–3.115,P=0.030),multiple lesions(HR=2.278,95%CI:1.621–3.195,P<0.001),and baseline tumor size>5 cm(HR=1.712,95%CI:1.031–2.849,P=0.038)were independent risk factors for RFS.Subgroup analysis showed that 67 of 93(72.0%)patients who received the combination of TACE,TKIs,and ICIs achieved MPR+CPR.Conclusions:In individuals who received TACE-based neoadjuvant therapy for HCC,failure to achieve MPR emerges as an independent risk factor for RFS.Notably,the combination of TACE,TKIs,and ICIs demonstrated the hi

关 键 词：Neoadjuvant therapy Hepatocellular carcinoma Major pathologic response Transarterial chemoembolization Tyrosine kinase inhibitors Immune checkpoint inhibitors 

分 类 号：R735.7[医药卫生—肿瘤]