Prognostic predictors for hepatocellular carcinoma patients receiving postoperative transcatheter arterial chemoembolization
作者单位：Department of Hepatobiliary Surgery The First Affiliated Hospital of Xi’an Jiaotong University Department of Hepatopancreatobiliary Surgery The Affiliated Hospital of Qinghai University Department of Hepatobiliary Surgery The Second Affiliated Hospital of Xi’an Jiaotong University Institute of Clinical Medical Sciences China-Japan Friendship Hospital
会议名称：《2018年中国肿瘤标志物学术大会暨第十二届肿瘤标志物青年科学家论坛》
会议日期：2018年
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
关 键 词：hepatocellular carcinoma postoperative adjuvant transcatheter arterial chemoembolization prognostic predictor propensity score matching
摘 要：Background & Aims: We aimed to confirm the clinical effectiveness of PA-TACE in HCC patients after liver resection, and further identify the patients who could benefit most from ***: Propensity score matching(PSM) at a ratio of 1:2 was used between hepatectomy patients with and without receiving PA-TACE. Kaplan-Meier analysis was performed to compare overall survival(OS) and recurrence-free survival(RFS) between two groups, univariate COX regression and stratified analysis were performed to screen and identify survival predictors for PA-TACE patients. The identified predictive markers were validated in an external ***: The propensity analysis matched 116 patients in PA-TACE group to 232 in the control group. Visible protective effect of PA-TACE was shown by survival curves in matched series(Log-rank P: 0.009 and 0.008), with hazard ratio of being 0.599(95% confidence interval [CI]: 0.420-0.855) and 0.623(95%CI: 0.449-0.866) respectively for OS and RFS. The identified prognostic predictors for PA-TACE included TNM stage, tumor size and number, hepatitis B infection, spleen diameter, preoperative serum alpha-fetoprotein(AFP), alkaline phosphatase(ALP), γ-glutamyl transpeptidase(GGT) and monocyte(MONO), and three risk signatures(aspartate aminotransferase-to-alanine aminotransferase ratio[AAR], neutrophil-to-lymphocyte ratio [NLR] and systemic immune-inflammation index[SII]).Conclusions: The treatment effectiveness of adjuvant TACE for HCC patients after surgery was validated in this study, and the best candidates for PA-TACE were identified as well, including patients with late-stage tumor, portal hypertension and high preoperative serum levels of AFP, ALP, GGT and monocytes.