Yun Yang1, Zheng Dang2, Peng Lu3, Youwen Qian4, Kongying Lin5, Zeya Pan1, Wan Yee Lau1,6, Weiping Zhou1,7,8. 1. The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China. 2. Department of Hepatobiliary Surgery, 940 Hospital of PLA Joint Logistic Support Force, Lanzhou, China. 3. Department of Hepatobiliary Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, China. 4. Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Shanghai, China. 5. Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China. 6. Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China. 7. Key Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer (SMMU), Ministry of Education, Shanghai, China. 8. Shanghai Key Laboratory of Hepatobiliary Tumor Biology (EHBH), Shanghai, China.
Abstract
Background: To study the influence of pathological responses (PR) after transcatheter arterial chemoembolization (TACE) on incidences of microvascular invasion (MVI) and early recurrence in hepatocellular carcinoma (HCC) patients. Methods: Between 2013 to 2015, consecutive HCC patients who underwent liver resection with "curative" intent at three hospitals were enrolled in this study. Patients with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI, early recurrence rates and patterns of recurrence before and after propensity score matching (PSM). Results: Of 1,970 patients, 737 patients who received preoperative TACE were divided into three groups according to the areas of PR: ≥90% (n=226), 60-90% (n=447), and <60% (n=64). PR ≥90% was an independent protective factor of incidences of MVI [odds ratio (OR), 0.144; 95% confidence interval (CI), 0.082-0.245, P<0.001) and early recurrence (HR, 0.742; 95% CI, 0.561-0.963, P=0.032); while PR<60% was an independent risk factor of incidences of MVI (OR, 6.076; 95% CI, 3.004-11.728, P<0.001) and early recurrence (HR, 1.428; 95% CI, 1.095-1.929; P=0.009). Furthermore, patients with PR <60% were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative TACE. Conclusions: This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor recurrence. Patients with PR <60% were at significantly higher risks of having more MVI, early and multiple tumor recurrences. 2022 Hepatobiliary Surgery and Nutrition. All rights reserved.
Background: To study the influence of pathological responses (PR) after transcatheter arterial chemoembolization (TACE) on incidences of microvascular invasion (MVI) and early recurrence in hepatocellular carcinoma (HCC) patients. Methods: Between 2013 to 2015, consecutive HCC patients who underwent liver resection with "curative" intent at three hospitals were enrolled in this study. Patients with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI, early recurrence rates and patterns of recurrence before and after propensity score matching (PSM). Results: Of 1,970 patients, 737 patients who received preoperative TACE were divided into three groups according to the areas of PR: ≥90% (n=226), 60-90% (n=447), and <60% (n=64). PR ≥90% was an independent protective factor of incidences of MVI [odds ratio (OR), 0.144; 95% confidence interval (CI), 0.082-0.245, P<0.001) and early recurrence (HR, 0.742; 95% CI, 0.561-0.963, P=0.032); while PR<60% was an independent risk factor of incidences of MVI (OR, 6.076; 95% CI, 3.004-11.728, P<0.001) and early recurrence (HR, 1.428; 95% CI, 1.095-1.929; P=0.009). Furthermore, patients with PR <60% were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative TACE. Conclusions: This study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor recurrence. Patients with PR <60% were at significantly higher risks of having more MVI, early and multiple tumor recurrences. 2022 Hepatobiliary Surgery and Nutrition. All rights reserved.
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