Transarterial chemoembolization combined with apatinib versus transarterial chemoembolization alone for hepatocellular carcinoma with macroscopic vascular invasion: A propensity score matching analysis

• Published in: Journal of cancer research and therapeutics Vol. 16; no. 5; pp. 1063 - 1068
• Main Authors: Shen, Lujun, Chen, Shuanggang, Qiu, Zhiyu, Qi, Han, Yuan, Hui, Cao, Fei, Xie, Lin, Chen, Qifeng, Li, Wang, Fan, Weijun
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.09.2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - therapy; Care and treatment; Chemoembolization; Chemoembolization, Therapeutic - methods; Combined Modality Therapy; Female; Follow-Up Studies; Hepatocellular carcinoma; Humans; Liver cancer; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Medical prognosis; Middle Aged; Neoplasm Invasiveness; Neovascularization, Pathologic - pathology; Neovascularization, Pathologic - therapy; Nivolumab; Prognosis; Propensity Score; Pyridines - therapeutic use; Retrospective Studies; Sorafenib; Survival Rate; Vascular Surgical Procedures - methods; Apatinib; macrovascular invasion; transarterial chemoembolization; hepatocellular carcinoma
• ISSN: 0973-1482; 1998-4138; 1998-4138
• DOI: 10.4103/jcrt.JCRT_801_19

Context: Macroscopic vascular invasion in hepatocellular carcinoma (HCC) remains challenging to treat. Aims: The aim of this study was to compare the efficacy of transarterial chemoembolization (TACE)-apatinib therapy with TACE treatment alone in HCC patients with macrovascular invasion, using propensity score matching (PSM). Settings and Design: Matched paired comparison between the TACE-apatinib and TACE alone group using 1:2 PSM was utilized. Subjects and Methods: Between 2013 and 2019, 378 patients receiving TACE-apatinib or TACE alone were included based on specific selection criteria. Statistical Analysis Used: Multivariate Cox regression models were used to determine the independent prognostic factors for overall survival (OS). Results: Of the patients included, 40 (12.5%) received TACE-apatinib treatment and 280 (87.5%) received TACE alone. Tumor sizes of patients in the TACE-apatinib group were more frequently classified as small (<5 cm) compared to those in the TACE alone group (P = 0.021; mean: 8.6 cm vs. 10.2 cm). After 1:2 PSM, 40 pairs of HCC patients with well-matched covariates were selected from the two treatment groups. Patients in the TACE-apatinib group had higher OS rates than patients in the TACE alone group (P = 0.018). The median OS times were 18.2 and 8.5 months in the TACE-apatinib and TACE alone groups, respectively. The OS hazard ratio for the choice of TACE-apatinib treatment compared to TACE treatment alone was 0.50 (95% confidence interval: 0.28-0.90; P = 0.021). Conclusions: TACE combined with apatinib may result in superior OS compared to TACE therapy alone for HCC patients with macrovascular invasion.