Background: Microvascular invasion (MVI) is a significant pathological feature in hepatocellular carcinoma (HCC), adjuvant hepatic arterial infusion chemotherapy (a-HAIC) and adjuvant transcatheter arterial chemoembolization (a-TACE), are commonly used for HCC patients with MVI. This study aims to evaluate the efficacies of two adjuvant therapies after surgical treatment for HCC, compare them, and identify the significant factors.
Methods: Clinical data from two randomized controlled trials involving HCC patients with MVI after surgical treatment were retrospectively reviewed. Propensity score matching (PSM) analysis was performed to balance baseline differences between patients who received a-HAIC or a-TACE, and control groups who underwent hepatectomy alone. Disease-free survival (DFS) and overall survival (OS) rates were compared.
Results: In total of 549 patients were collected from two randomized controlled trials. Using the PSM and Kaplan-Meier method, the median DFS of the a-HAIC, a-TACE, and control groups was 63.2, 21.7, and 11.2 months (P< 0.05). The a-HAIC group show significantly better 1-, 3-, and 5-year OS rates compared to the a-TACE and control groups (96.3%, 80.0%, 72.8% vs 84.4%, 57.0%, 29.8% vs 84.5%, 62.8%, 53.4%, P< 0.05). But the OS rates of a-TACE and control groups showed no significant difference (P=0.279). Multivariate analysis identified a-HAIC (HR=0.449, P=0.000) and a-TACE (HR=0.633, P=0.007) as independent protective factors. For OS, a-HAIC (HR=0.388, P=0.003) was identified as an independent protective factor, too.
Conclusion: Compared to a-TACE and the control group, a-HAIC demonstrated greater benefits in preventing tumor recurrence and improving survival in HCC patients with MVI.



中文翻译：

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肝动脉灌注化疗与经导管动脉化疗栓塞作为 MVI 阳性肝细胞癌术后辅助治疗：多中心倾向评分匹配分析

背景：微血管侵犯（MVI）是肝细胞癌（HCC）的重要病理特征，辅助肝动脉灌注化疗（a-HAIC）和辅助经导管动脉化疗栓塞（a-TACE）常用于治疗合并MVI的HCC患者。本研究旨在评估 HCC 手术治疗后两种辅助疗法的疗效，进行比较，并确定重要因素。
方法：回顾性分析两项随机对照试验的临床数据，涉及手术治疗后发生 MVI 的 HCC 患者。进行倾向评分匹配 (PSM) 分析，以平衡接受 a-HAIC 或 a-TACE 的患者与仅接受肝切除术的对照组之间的基线差异。比较无病生存率（DFS）和总生存率（OS）。
结果：两项随机对照试验总共收集了 549 名患者。采用 PSM 和 Kaplan-Meier 方法，a-HAIC、a-TACE 和对照组的中位 DFS 分别为 63.2、21.7 和 11.2 个月（P< 0.05）。与 a-TACE 组和对照组相比，a-HAIC 组的 1 年、3 年和 5 年 OS 率显着提高（96.3%、80.0%、72.8% vs 84.4%、57.0%、29.8% vs 84.5%） , 62.8%, 53.4%, P< 0.05)。但a-TACE组与对照组的OS率无显着性差异（P =0.279）。多变量分析确定a-HAIC（HR=0.449，P =0.000）和a-TACE（HR=0.633，P =0.007）为独立保护因素。对于 OS，a-HAIC（HR=0.388，P =0.003）也被确定为独立的保护因素。
结论：与a-TACE和对照组相比，a-HAIC在预防MVI HCC患者的肿瘤复发和提高生存方面表现出更大的益处。