ABSTRACT
Context and Aims: Apatinib combined with transarterial chemoembolization (TACE) has shown promising results in cases of Barcelona clinic liver cancer Stage C (BCLC C) hepatocellular carcinoma (HCC). This study aimed to investigate the efficacy and safety of TACE in combination with microwave ablation (MWA) and apatinib. Materials and Methods: A retrospective, single.center study was undertaken using a one.to.one propensity score matching (PSM) analysis design and involved BCLC C HCC patients who underwent treatment with TACE.MWA.apatinib or TACE alone between January 2013 and June 2018. The patients were recommended to administer 500mg apatinib per day, combined with MWA and TACE. The adverse effects of apatinib, MWA. and TACE.related complications, progression.free survival (PFS), and overall survival (OS) were assessed. Results: Of the 149 patients with BCLC C HCC who underwent TACE.MWA.apatinib or TACE alone, 131 were included in our study. Among them, 21 (16.0%) received TACE.MWA.apatinib and 110 (84.0%) underwent TACE alone. After PSM, twenty pairs were enrolled into different treatment groups. Patients in the TACE.MWA.apatinib group had a significantly longer median PFS than patients in the TACE.alone group on both before (median, 8.9 vs. 1.7 months, P = 0.0002) and after PSM (median, 5.4 vs. 2.1 months, P = 0.001). They also had a significantly longer median OS than patients in the TACE.alone group on before (median, 24.4 vs. 5.8 months, P = 0.000007) and after PSM (median, 24.4 vs. 5.4 months, P = 0.00005). Conclusions: The combination of apatinib, TACE, and MWA in BCLC C HCC patients is safe and effective. Toxicity is manageable by adjusting the apatinib dosage
ABSTRACT
Objective To investigate the long time prognosis of liver resection or transcatheter arterial chemoembolization(TACE) of Barcelona clinic liver cancer stage C(BCLC-C) patients who have portal vein tumor thrombsis.Methods Totally 86 BCLC-C patients who satisfied our including criteria from our surgical database of People's Hospital of Yichang City from January 2000 to September 2015 were selected as the research object.According to different treatment,86 patients were divided into liver resection group(n=50) and TACE group(n=36).The general information of two groups were compared.Cox multi-factors analysis and overall survival rate were calculated.ResultsThe long-term prognosis of liver resection group was better than that of TACE group(5-year OS:26% vs.0,P40 IU/L(HR:0.615,95%CI[0.488,1.206],P=0.013) as well as HBV-DNA>1 000(HR:1.204,95%CI:[0.920,2.540],P=0.038)were adverse factors for prognosis.ConclusionLiver resection is better than TACE for BCLC-C patients with portal vein tumor thrombosis.However,randomized controlled trial still need to be used to further confirm our conclusion.