Hepatic arterial infusion chemotherapy and sequential ablation treatment in large hepatocellular carcinoma. (31st December 2022)

• Record Type: Journal Article
• Authors: You, Huimin; Liu, Xingyi; Guo, Jiandong; Lin, Yinsheng; Zhang, Yan; Li, Chengzhi
• Is Part Of: International journal of hyperthermia. Volume 39:Number 1(2022)
• Page Start: 1097
• Page End: 1105
• Publication Date: 2022-12-31
• Subjects: Hepatocellular carcinoma -- hepatic arterial infusion -- ablation -- up-to-seven criteria -- predictive model; Thermotherapy -- Periodicals; 615.832
• DOI: 10.1080/02656736.2022.2112307
• Languages: English
• ISSNs: 0265-6736

Abstract

Abstract: Aim: To investigate the individualized survival benefit of hepatic arterial infusion chemotherapy (HAIC) and sequential ablation treatment in large hepatocellular carcinoma (HCC) patients. Methods: Between February 2016 and December 2020, a total of 228 HCC patients (diameter > 5 cm) who underwent HAIC alone (HAIC group, n = 135) or HAIC and sequential ablation (HAIC-ablation group, n = 93) treatment were reviewed. We applied the inverse probability of treatment weighting (IPTW) to adjust for potential bias of two treatment groups. The overall survival (OS) and progression-free survival (PFS) were compared with Kaplan–Meier curves. The Cox regression model was used to identify independent prognostic factors. And a prediction nomogram based on these independent prognostic factors was built, aiming to make probabilistic survival predictions and estimate personalized ablation benefits. Results: After a median follow-up of 17.9 months, HCC patients in the HAIC-ablation group have longer significantly OS and PFS than those in the HAIC alone group (median OS: 22.2 months vs. 14.5 months; median PFS: 8.5 months vs. 4.6 months; both, p < 0.001). The IPTW-adjusted analysis revealed similar findings (both, p < 0.001). Tumor size, tumor number, and treatment modality were identified as independent prognostic factors for OS. The nomogram based on these factors showed favorable discrimination and well calibration. Conclusions: HAIC and sequential ablation provided significant survival benefits in patients with large HCC. The nomogram could help predict individual survival probabilities and estimate personalized sequential ablation benefits.