Abstract 225P
Background
Adjuvant transarterial chemoembolization (TACE) is strongly recommended by the China Liver Cancer guideline in patients with hepatocellular carcinoma (HCC) at high-risk of recurrence. This study aims to evaluate the safety and efficacy of real adjuvant TACE in HCC patients after curative resection.
Methods
Between June 2019 and December 2023, patients with high-risk recurrent factors after curative resection from three centers might be enrolled. Patients with tumor staining during TACE procedure were regarded as those who underwent palliative resection. Recurrence-free survival (RFS), overall survival (OS), and adverse events were carefully evaluated in different patient groups. Propensity score matching was used.
Results
A total of 1,390 patients were analyzed, with 957 (68.8%) receiving postoperative active surveillance. Among the 433 (31.2%) patients who underwent postoperative TACE, only 315 (72.7%) patients were without intraoperative tumor staining (curative resection). These patients were classified as receiving adjuvant TACE. Patients treated with postoperative TACE (n=433) showed significant improvements in both RFS (HR 0.82, 95% CI 0.71-0.93) and OS (HR 0.81, 95% CI 0.67-0.98) compared to patients with active surveillance. However, the RFS (HR 0.92, 95% CI 0.80-1.08) and OS (HR 0.86, 95% CI 0.70-1.06) were virtually identical between patients receiving adjuvant TACE (n=315) and those who under active surveillance, and these findings remained similar after propensity score matching. Subgroup analyses found that only patients with microvascular invasion were likely to benefit from adjuvant TACE (RFS: HR 0.75, 95% CI 0.61-0.93; OS: HR 0.62, 95% CI 0.42-0.84). Adjuvant TACE-related adverse events were mostly mild and tolerable, with grade 3 severity predominantly in hepatic impairment, nausea/vomiting, and thrombocytopenia. Grade 4 or 5 adverse event was not observed.
Conclusions
Adjuvant TACE does not improve the survival of most HCC patients with high-risk recurrent factors after curative resection.
Clinical trial identification
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.