Impact of neoadjuvant therapy on the prognosis of hepatectomy for hepatocellular carcinoma based on a propensity score matched analysis
10.3760/cma.j.cn113884-20250112-00013
- VernacularTitle:基于倾向性评分匹配分析新辅助治疗对肝细胞癌肝切除术预后的影响
- Author:
Hao WU
1
;
Shubo PAN
1
;
Fuqing PEI
1
;
Zeyuan YIN
1
;
Yuyong ZHU
1
;
Qiru XIONG
1
;
Shengxue XIE
1
;
Hui HOU
1
;
Jiong GU
1
;
Liquan YU
1
Author Information
1. 安徽医科大学第二附属医院肝胆外科，合肥 230000
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Neoadjuvant therapy;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(11):806-810
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Based on a propensity score matchied analysis, the impact of neoadjuvant therapy, namely the transcatheter arterial chemoembolization (TACE) combined with the targeted and immunotherapy, on the prognosis of patients undergoing liver resection for hepatocellular carcinoma (HCC).Methods:Clinical data of 226 patients who underwent surgical resection for HCC of China Liver Cancer (CNLC) stage Ib, IIa, IIb, and IIIa at the Second Affiliated Hospital of Anhui Medical University from February 2020 to December 2024 were retrospectively analyzed, including 201 males and 25 females, aged 64.6±9.4 years. Patients were divided into the neoadjuvant therapy group ( n=25) and the direct surgery group ( n=201). Propensity score matching was used to analyze the liver fibrosis-4 score, platelet count, prothrombin time, activated partial thromboplastin time, and tumor number of the two groups. Postoperative pathological assessment of liver resection was performed. The Kaplan-Meier method was used to analyze the prognosis, and the log-rank test was used to compare the survival rates of the two groups. Results:After propensity score 1: 3 matching, there were no statistically significant differences (all P>0.05) regarding the baseline characteristics of the two groups. Pathological assessment after hepatectomy: the complete pathological response rate was 8% (2/25), and the major pathological response rate was 36% (9/25). The recurrence-free survival rates at 1, 2, and 3 years after surgery in the direct surgery group and the neoadjuvant therapy group were 52.0%, 48.0%, and 42.7% versus 76.0%, 72.0%, and 68.0%, respectively ( χ2=4.76, P=0.029). The overall survival rates at 1, 2, and 3 years after surgery in the direct surgery group and the neoadjuvant therapy group were 80.0%, 78.7%, and 77.3% versus 100.0%, 96.0%, and 96.0%, respectively ( χ2=4.31, P=0.038). Conclusion:Neoadjuvant therapy could reduce the risk of postoperative recurrence and prolong patients survival
