Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma
Yangshuo Xia,1,* Wu Wen,1,* Yangyu Liao,2,* Yingxiao Cai,1 Renhua Wan1 1Department of Hepatobiliary Surgery, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, People’s Republic of China; 2Department of Oncology, Nanchang University’s First Affili...
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Dove Medical Press
2025-07-01
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| Series: | Journal of Hepatocellular Carcinoma |
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| Online Access: | https://www.dovepress.com/adjuvant-hepatic-arterial-infusion-chemotherapy-versus-transarterial-c-peer-reviewed-fulltext-article-JHC |
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| author | Xia Y Wen W Liao Y Cai Y Wan R |
| author_facet | Xia Y Wen W Liao Y Cai Y Wan R |
| author_sort | Xia Y |
| collection | DOAJ |
| description | Yangshuo Xia,1,* Wu Wen,1,* Yangyu Liao,2,* Yingxiao Cai,1 Renhua Wan1 1Department of Hepatobiliary Surgery, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, People’s Republic of China; 2Department of Oncology, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Renhua Wan, Department of Hepatobiliary Surgery, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, China, No. 17 Yongwaizheng Street, Donghu District, Nanchang, People’s Republic of China, Email zww726696@sina.comPurpose: HCC exhibits a high postoperative recurrence rate, with early recurrence (≤ 2 years) accounting for 70% of cases, predominantly associated with high-risk recurrence factors. Common adjuvant therapies for HCC include postoperative adjuvant hepatic arterial infusion chemotherapy (PA-HAIC) and postoperative adjuvant transarterial chemoembolization (PA-TACE). This study evaluates the comparative efficacy and safety of PA-HAIC versus PA-TACE in preventing early recurrence among HCC patients with postoperative high-risk recurrence factors.Patients and Methods: A retrospective analysis included 170 HCC patients with high-risk recurrence factors following surgical resection (2018– 2023), divided into PA-HAIC (n=23) and PA-TACE (n=147) groups. To mitigate potential biases and adjust for baseline characteristics, propensity score matching (PSM) was performed. Survival analyses for two primary endpoints, recurrence-free survival (RFS) and overall survival (OS), were then conducted using the Kaplan-Meier method and Cox proportional hazards regression. Adverse event (AE) rates and severity were compared.Results: Post-PSM analysis revealed significantly superior RFS rates in the PA-HAIC group versus PA-TACE at 6,12,and 24 months (100%, 95.7%, 95.7% vs 91.3%, 73.9%, 65.2%;p=0.0085). Multivariable Cox regression identified PA-HAIC (HR=0.20, 95% CI:0.02– 0.71;p=0.020) and intact tumor capsule (HR=0.02, 95% CI:0.00– 0.41;p=0.011) as independent protective factors for RFS, while vascular tumor thrombus (HR=28.02, 95% CI:2.07– 378.81;p=0.012) emerged as a risk factor. Subgroup analyses identified age ≥ 50 years, solitary tumors, BCLC-A stage, absence of MVI, intact capsule, and no vascular thrombus as low-risk factors for early recurrence. Safety profiles showed no significant between-group differences in AE incidence or severity.Conclusion: Among HCC patients with high-risk recurrence factors after surgical resection, PA-HAIC demonstrated significantly prolonged RFS compared to PA-TACE, with a favorable safety profile.Keywords: hepatocellular carcinoma, adjuvant therapy, hepatic arterial infusion chemotherapy, propensity score-matched, transarterial chemoembolization |
| format | Article |
| id | doaj-art-d1272c5b32bf49449a0ece73f47629a3 |
| institution | DOAJ |
| issn | 2253-5969 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Dove Medical Press |
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| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj-art-d1272c5b32bf49449a0ece73f47629a32025-08-20T02:39:48ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692025-07-01Volume 12Issue 114251439104888Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular CarcinomaXia Y0Wen W1Liao Y2Cai Y3Wan R4Department of General SurgeryDepartment of General SurgeryDepartment of OncologyDepartment of General SurgeryDepartment of General SurgeryYangshuo Xia,1,* Wu Wen,1,* Yangyu Liao,2,* Yingxiao Cai,1 Renhua Wan1 1Department of Hepatobiliary Surgery, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, People’s Republic of China; 2Department of Oncology, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Renhua Wan, Department of Hepatobiliary Surgery, Nanchang University’s First Affiliated Hospital, Nanchang, Jiangxi, China, No. 17 Yongwaizheng Street, Donghu District, Nanchang, People’s Republic of China, Email zww726696@sina.comPurpose: HCC exhibits a high postoperative recurrence rate, with early recurrence (≤ 2 years) accounting for 70% of cases, predominantly associated with high-risk recurrence factors. Common adjuvant therapies for HCC include postoperative adjuvant hepatic arterial infusion chemotherapy (PA-HAIC) and postoperative adjuvant transarterial chemoembolization (PA-TACE). This study evaluates the comparative efficacy and safety of PA-HAIC versus PA-TACE in preventing early recurrence among HCC patients with postoperative high-risk recurrence factors.Patients and Methods: A retrospective analysis included 170 HCC patients with high-risk recurrence factors following surgical resection (2018– 2023), divided into PA-HAIC (n=23) and PA-TACE (n=147) groups. To mitigate potential biases and adjust for baseline characteristics, propensity score matching (PSM) was performed. Survival analyses for two primary endpoints, recurrence-free survival (RFS) and overall survival (OS), were then conducted using the Kaplan-Meier method and Cox proportional hazards regression. Adverse event (AE) rates and severity were compared.Results: Post-PSM analysis revealed significantly superior RFS rates in the PA-HAIC group versus PA-TACE at 6,12,and 24 months (100%, 95.7%, 95.7% vs 91.3%, 73.9%, 65.2%;p=0.0085). Multivariable Cox regression identified PA-HAIC (HR=0.20, 95% CI:0.02– 0.71;p=0.020) and intact tumor capsule (HR=0.02, 95% CI:0.00– 0.41;p=0.011) as independent protective factors for RFS, while vascular tumor thrombus (HR=28.02, 95% CI:2.07– 378.81;p=0.012) emerged as a risk factor. Subgroup analyses identified age ≥ 50 years, solitary tumors, BCLC-A stage, absence of MVI, intact capsule, and no vascular thrombus as low-risk factors for early recurrence. Safety profiles showed no significant between-group differences in AE incidence or severity.Conclusion: Among HCC patients with high-risk recurrence factors after surgical resection, PA-HAIC demonstrated significantly prolonged RFS compared to PA-TACE, with a favorable safety profile.Keywords: hepatocellular carcinoma, adjuvant therapy, hepatic arterial infusion chemotherapy, propensity score-matched, transarterial chemoembolizationhttps://www.dovepress.com/adjuvant-hepatic-arterial-infusion-chemotherapy-versus-transarterial-c-peer-reviewed-fulltext-article-JHCHepatocellular carcinomaadjuvant therapyhepatic arterial infusion chemotherapy；Propensity Score-Matched；transarterial chemoembolization; |
| spellingShingle | Xia Y Wen W Liao Y Cai Y Wan R Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma Journal of Hepatocellular Carcinoma Hepatocellular carcinoma adjuvant therapy hepatic arterial infusion chemotherapy；Propensity Score-Matched；transarterial chemoembolization; |
| title | Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma |
| title_full | Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma |
| title_fullStr | Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma |
| title_full_unstemmed | Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma |
| title_short | Adjuvant Hepatic Arterial Infusion Chemotherapy Versus Transarterial Chemoembolization for Preventing Early Recurrence After Surgical Resection in Hepatocellular Carcinoma |
| title_sort | adjuvant hepatic arterial infusion chemotherapy versus transarterial chemoembolization for preventing early recurrence after surgical resection in hepatocellular carcinoma |
| topic | Hepatocellular carcinoma adjuvant therapy hepatic arterial infusion chemotherapy；Propensity Score-Matched；transarterial chemoembolization; |
| url | https://www.dovepress.com/adjuvant-hepatic-arterial-infusion-chemotherapy-versus-transarterial-c-peer-reviewed-fulltext-article-JHC |
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