Ming-Song Wu, Yun Ma, Kang Chen, Cheng-Piao Luo, Jie Zhang, Yu-Jie Zhou, Jian-Hong Zhong*, Bang-De Xiang*
Wu et al. J Clin Transl Res 2022, 8(1):9
Published online: January 25, 2022
Abstract
Background & Aim: This study retrospectively explored the potential association between CK19 expression and efficacy of adjuvant conventional transarterial chemoembolization (TACE) after hepatic resection in patients with hepatocellular carcinoma (HCC) at high risk of recurrence.
Methods: Patients (n=508) who underwent hepatic resection between January 2012 and December 2017 were enrolled. Overall survival (OS) and recurrence-free survival (RFS) were compared between groups. Survival analysis was performed using the Kaplan-Meier method, and groups were compared using the log-rank test.
Results: OS and RFS were worse for CK19-positive patients than for CK19-negative patients, regardless of whether patients were matched on the basis of propensity scores. Among CK19-positive patients in the absence of propensity score matching, TACE was associated with better RFS. Among CK19-negative patients in the absence of propensity matching, TACE was associated with better OS and RFS. Among patients treated with TACE, CK19-positive patients showed worse OS but similar RFS as CK19-negative patients. Multivariate analysis identified the following independent predictors of worse OS: CK19 positivity, no adjuvant TACE, macrovascular invasion, microvascular invasion, tumor size >5 cm, alanine transaminase >80 U/L, and aspartate transaminase >80 U/L. Multivariate analysis identified the following predictors of worse RFS: CK19 positivity, no adjuvant TACE, age ≥60 years, alpha-fetoprotein ≥400 ng/ml, and Barcelona Clinic Liver Cancer stage B/C.
Conclusion: This study suggest that among HCC patients at high risk of recurrence, adjuvant TACE can significantly prolong OS and RFS of CK19-negative patients, while it may prolong only RFS of CK19-positive patients.
Relevance for patients: Not all patients will benefit from adjuvant TACE, therefore, it is necessary to select the best benefit subsets before TACE. By study the relationship between CK19 expression and TACE benefit, it will be possible to help guide decision-making about adjuvant TACE in HCC patients at high risk of recurrence.
DOI: http://dx.doi.org/10.18053/jctres.08.202201.009
Author affilation
1. Hepatobiliary Surgery Department, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning 530021, China
2. Oncology Department, Wuzhou Hospital of Traditional Chinese Medicine, Wuzhou 543000, China
3. Pathology Department, Guangxi Medical University Cancer Hospital, Nanning 530021, China
*Corresponding author
Bang-De Xiang
Hepatobiliary Surgery Department, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning 530021, China
Email: 1468751916@qq.com
Jian-Hong Zhong
Hepatobiliary Surgery Department, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning 530021, China
Email: zhongjianhong@gxmu.edu.cn
Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China
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