Lujun Shen1, Shuanggang Chen1, Zhiyu Qiu2, Han Qi1, Hui Yuan1, Fei Cao1, Lin Xie1, Qifeng Chen1, Wang Li1, Weijun Fan1. 1. Department of Minimally Invasive Interventional Therapy, Sun Yat-Sen University Cancer Center; Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, China. 2. Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China; Zhongshan School of Medical, Sun Yat-Sen University, Guangzhou, China.
Abstract
CONTEXT: Macroscopic vascular invasion in hepatocellular carcinoma (HCC) remains challenging to treat. AIMS: The aim of this study was to compare the efficacy of transarterial chemoembolization (TACE)-apatinib therapy with TACE treatment alone in HCC patients with macrovascular invasion, using propensity score matching (PSM). SETTINGS AND DESIGN: Matched paired comparison between the TACE-apatinib and TACE alone group using 1:2 PSM was utilized. SUBJECTS AND METHODS: Between 2013 and 2019, 378 patients receiving TACE-apatinib or TACE alone were included based on specific selection criteria. STATISTICAL ANALYSIS USED: Multivariate Cox regression models were used to determine the independent prognostic factors for overall survival (OS). RESULTS: Of the patients included, 40 (12.5%) received TACE-apatinib treatment and 280 (87.5%) received TACE alone. Tumor sizes of patients in the TACE-apatinib group were more frequently classified as small (<5 cm) compared to those in the TACE alone group (P = 0.021; mean: 8.6 cm vs. 10.2 cm). After 1:2 PSM, 40 pairs of HCC patients with well-matched covariates were selected from the two treatment groups. Patients in the TACE-apatinib group had higher OS rates than patients in the TACE alone group (P = 0.018). The median OS times were 18.2 and 8.5 months in the TACE-apatinib and TACE alone groups, respectively. The OS hazard ratio for the choice of TACE-apatinib treatment compared to TACE treatment alone was 0.50 (95% confidence interval: 0.28-0.90; P = 0.021). CONCLUSIONS: TACE combined with apatinib may result in superior OS compared to TACE therapy alone for HCC patients with macrovascular invasion.
CONTEXT: Macroscopic vascular invasion in hepatocellular carcinoma (HCC) remains challenging to treat. AIMS: The aim of this study was to compare the efficacy of transarterial chemoembolization (TACE)-apatinib therapy with TACE treatment alone in HCC patients with macrovascular invasion, using propensity score matching (PSM). SETTINGS AND DESIGN: Matched paired comparison between the TACE-apatinib and TACE alone group using 1:2 PSM was utilized. SUBJECTS AND METHODS: Between 2013 and 2019, 378 patients receiving TACE-apatinib or TACE alone were included based on specific selection criteria. STATISTICAL ANALYSIS USED: Multivariate Cox regression models were used to determine the independent prognostic factors for overall survival (OS). RESULTS: Of the patients included, 40 (12.5%) received TACE-apatinib treatment and 280 (87.5%) received TACE alone. Tumor sizes of patients in the TACE-apatinib group were more frequently classified as small (<5 cm) compared to those in the TACE alone group (P = 0.021; mean: 8.6 cm vs. 10.2 cm). After 1:2 PSM, 40 pairs of HCC patients with well-matched covariates were selected from the two treatment groups. Patients in the TACE-apatinib group had higher OS rates than patients in the TACE alone group (P = 0.018). The median OS times were 18.2 and 8.5 months in the TACE-apatinib and TACE alone groups, respectively. The OS hazard ratio for the choice of TACE-apatinib treatment compared to TACE treatment alone was 0.50 (95% confidence interval: 0.28-0.90; P = 0.021). CONCLUSIONS: TACE combined with apatinib may result in superior OS compared to TACE therapy alone for HCC patients with macrovascular invasion.
Authors: Weihua Zhang; Lei Chen; Yanyan Cao; Bo Sun; Yanqiao Ren; Tao Sun; Chuansheng Zheng Journal: Cancer Manag Res Date: 2021-07-06 Impact factor: 3.989