Abstract 224P
Background
Whether neoadjuvant therapy is necessary for resectable intermediate or advanced hepatocellular carcinoma (HCC) is a controversial and important clinical issue. This study will be the first to explore whether neoadjuvant therapy is warranted for resectable intermediate or advanced HCC.
Methods
Data were retrospectively compared for patients with initially resectable HCC at 20 medical centers in China who underwent neoadjuvant therapy (n = 459) or initial hepatectomy (n = 343) between January 2019 and June 2023. The two groups and subgroups were compared in terms of overall survival, event-free survival, recurrence-free survival, neoadjuvant therapy-related adverse events, and postoperative characteristics.
Results
Compared to the patients who received neoadjuvant therapy, patients who received initial hepatectomy showed significantly better overall survival (HR 0.56, 95%CI 0.40–0.78, p < 0.001). There was no significant difference in event-free survival between the two groups before and after propensity score matching (all p > 0.05). In addition, there was no significant difference in overall survival and recurrence-free survival between initial hepatectomy group and neoadjuvant therapy sequential hepatectomy group before and after propensity matching analyses (all p > 0.05). However, overall survival in patients undergoing neoadjuvant therapy sequential hepatectomy was significantly better than that in patients without hepatectomy (all p < 0.001). On the other hand, neoadjuvant therapy may cause serious adverse events (25.6%) but reduce postoperative complications.
Conclusions
Neoadjuvant therapy does not seem necessary for resectable intermediate or advanced stage HCC.
Clinical trial identification
NCT06405321.
Editorial acknowledgement
Legal entity responsible for the study
The Ethics Committee of Guangxi Medical University Cancer Hospital.
Funding
This work was supported by the Specific Research Project of Guangxi for Research Bases and Talents (GuiKe AD22035057), Guangxi Key Research and Development Plan Project (GuiKe AB24010082), First-class Discipline Innovation-Driven Talent Program of Guangxi Medical University.
Disclosure
All authors have declared no conflicts of interest.