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Objective:The study aimed to study the efficacy and safety of combined dual therapy using anti-programmed death (PD)-1 and tyrosine kinase inhibitor (TKI) with combined triple therapy using anti-PD-1, TKI and locoregional intervention triple therapy in patients with postoperative refractory recurrent liver cancer.Methods:Patients with postoperative refractory recurrent liver cancer who had undergone either anti-PD-1 and TKI dual therapy or anti-PD-1, TKI and locoregional intervention triple therapy between July 2016 and March 2019 at the First Medical Center, Chinese PLA General Hospital were retrospectively studied. Tumor responses were assessed by the modified response evaluation criteria in solid tumors and overall survival and progression free survival were compared. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events.Results:Of 63 patients who were included in this study, there were 25 patients in the dual therapy group (16 males and 9 females, aged 54.3±8.8 years) and 38 patients in the triple therapy group (31 males and 7 females, aged 55.5±8.4 years). The 1-year survival rate of the triple therapy group was significantly higher than the dual therapy group (94.5%vs 54.9%) ( P<0.01). The disease control rate was 64.0% (16/25) in the dual therapy group and 84.2% (32/38) in the triple therapy group, and the difference was not significant ( P>0.05). The incidence of treatment-related adverse events in the triple therapy group and the dual therapy group were 78.9% (30/38) and 80% (20/25), respectively. There was no treatment-related death in the 2 groups. Conclusions:Anti-PD-1 and TKI dual therapy and anti-PD-1, TKI and locoregional intervention triple therapy were effective and tolerable treatments for postoperative refractory recurrent liver cancer. The latter treatment had a significantly better clinical benefit on survival outcomes.
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Objective@#To analyze the impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis in hepatitis B virus-related hepatocellular carcinoma (HBV related HCC) patients.@*Methods@#A retrospective study was conducted on 157 HBV related HCC patients who underwent treatment at the Chinese PLA General Hospital from January 2016 to December 2017. There were 128 males and 29 females. The mean age was (54.5±12.1) years. These patients were divided into 106 patients who underwent Pringle’s maneuver (the Pringle’s maneuver group). The remaining patients were in the Occlusion-free group. All patients were detected inflammatory mediator levels including the various interleukins (IL) and were regularly followed up. The recurrence-free survival was evaluated by the Kaplan-Meier method, and compared with the log-rank test. The relationship between the Pringle’s maneuver and risks of postoperative tumor recurrence of these patient were estimated by the univariate and multivariate Cox regression models.@*Results@#On postoperation day 1 and day 3, the serum IL-1 and IL-6 levels of the Pringle’s maneuver group were significantly higher than the Occlusion-free group [5.0(5.0, 12.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [122.0(74.5, 173.8)ng/L vs. 80.0(40.0, 120.0)ng/L]; [5.0(5.0, 10.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [78.3(42.8, 138.5)ng/L vs. 48.1(30.1, 75.0)ng/L]. On day 5, the serum IL-1 and IL-8 levels were also significantly higher than the Occlusion-free group [5.0(5.0, 5.3)ng/L vs. 5.0(5.0, 5.0)ng/L], [100.6 (44.2, 186.5)g/L vs. 68.0(36.3, 112.0)ng/L] (all P<0.05). There were 42 and 27 patients who did not develop recurrence in the Pringle’s Maneuver group and the Occlusion-free group, respectively. The recurrence-free survival rates of the Pringle maneuver group and the Occlusion-free group were 40.0% and 52.9%, respectively. There were no significant differences between the two groups (P>0.05). The multivariate Cox regression model suggested that there was no significant correlation between Pringle’s maneuver and recurrence free survival of these patients with HBV related HCC.@*Conclusions@#Pringle’s maneuver could significantly elevate the postoperative serum IL-1, IL-6, IL-8 levels, but it was not related with an increased risk of postoperative tumor recurrence.