Adjuvant hepatic arterial infusion chemotherapy is beneficial for selective patients with Hepatocellular carcinoma undergoing surgical treatment
Recurrence rate after curative surgical resection of Hepatocellular carcinoma (HCC) remains high. Postoperative hepatic arterial infusion chemotherapy (HAIC) has been suggested to improve survival. This study is to investigate the efficacy of HAIC in the patients with poor tumor factors such as vasc...
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| Veröffentlicht in: | International journal of surgery (London, England) England), 2017-09, Vol.45, p.35-41 |
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| creator | Hsiao, Jui-Hu Tsai, Cheng-Chung Liang, Tsung-Jung Chiang, Chia-Ling Liang, Huei-Lung Chen, I-Shu Chen, Yu-Chia Chang, Po-Ming Chou, Nan-Hua Wang, Being-Whey |
| description | Recurrence rate after curative surgical resection of Hepatocellular carcinoma (HCC) remains high. Postoperative hepatic arterial infusion chemotherapy (HAIC) has been suggested to improve survival. This study is to investigate the efficacy of HAIC in the patients with poor tumor factors such as vascular invasion or multiplicity.
From 2006 to 2014, 221 patients with HCC undergoing hepatectomy and pathologically staged as ≧ T2 (American Joint Committee on Cancer TNM staging system, 7th edition) were included. 61 patients received adjuvant HAIC with 5-fluorouracil, cisplatin, and epirubicin. 160 patients received surgery alone. The overall survival time (OST) and disease free survival time (DFST) were compared between the two groups.
In all patients, the multivariate analysis of survival data showed that resection margin less than 10 mm was the independent poor prognostic factors. The median OST and DFST between the HAIC and surgery alone groups were 56.4 vs. 56.9 months (p = 0.76), and 50.6 vs. 54.5 months (p = 0.905), respectively. There was no significant difference. For patients with multiple tumors and concomitantly microvascular invasion, the OST was better in the HAIC group (69.7 vs. 54.6 months, p |
| doi_str_mv | 10.1016/j.ijsu.2017.07.071 |
| format | Article |
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From 2006 to 2014, 221 patients with HCC undergoing hepatectomy and pathologically staged as ≧ T2 (American Joint Committee on Cancer TNM staging system, 7th edition) were included. 61 patients received adjuvant HAIC with 5-fluorouracil, cisplatin, and epirubicin. 160 patients received surgery alone. The overall survival time (OST) and disease free survival time (DFST) were compared between the two groups.
In all patients, the multivariate analysis of survival data showed that resection margin less than 10 mm was the independent poor prognostic factors. The median OST and DFST between the HAIC and surgery alone groups were 56.4 vs. 56.9 months (p = 0.76), and 50.6 vs. 54.5 months (p = 0.905), respectively. There was no significant difference. For patients with multiple tumors and concomitantly microvascular invasion, the OST was better in the HAIC group (69.7 vs. 54.6 months, p < 0.05).
Based on the image and operative finding, we classified multiple HCC's into two types. Type A: multiple small nodules were close to each other or a huge tumor with several satellite nodules. Type B: two or more tumors scattering in separate segments. Our study showed that type A group benefits from adjuvant HAIC much more than type B. (the median OST in type A versus type B were 85.06 vs. 41.53 months, p = 0.0036).
The surgical outcome for the patients with multiple HCC's and vascular invasion was poor. Our study showed adjuvant HAIC was beneficial in these patients and formed the basis for further randomized controlled trials.
•HAIC provided benefit for HCC patients with microvascular invasion and selective multiple tumor after surgery.•HAIC is not suitable for every patients undergoing surgery.•Solitary HCC patients should not receive adjuvant HAIC, especially in non-HBV patients.</description><identifier>ISSN: 1743-9191</identifier><identifier>EISSN: 1743-9159</identifier><identifier>DOI: 10.1016/j.ijsu.2017.07.071</identifier><identifier>PMID: 28728985</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Carcinoma, Hepatocellular - drug therapy ; Carcinoma, Hepatocellular - surgery ; Chemotherapy, Adjuvant - methods ; Cisplatin - administration & dosage ; Disease-Free Survival ; Epirubicin - administration & dosage ; Female ; Fluorouracil - administration & dosage ; Hepatectomy ; Hepatic arterial infusion chemotherapy ; Hepatocellular carcinoma ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms - drug therapy ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Multiple tumor ; Neoplasm Staging ; Patient Selection ; Retrospective Studies ; Survival ; Survival Rate ; Treatment Outcome</subject><ispartof>International journal of surgery (London, England), 2017-09, Vol.45, p.35-41</ispartof><rights>2017 IJS Publishing Group Ltd</rights><rights>Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-18b4fe94c40d37c3d1c68f147d697a87107778cb4522510377f5f720adcf7f053</citedby><cites>FETCH-LOGICAL-c400t-18b4fe94c40d37c3d1c68f147d697a87107778cb4522510377f5f720adcf7f053</cites><orcidid>0000-0002-6417-0186</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijsu.2017.07.071$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28728985$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsiao, Jui-Hu</creatorcontrib><creatorcontrib>Tsai, Cheng-Chung</creatorcontrib><creatorcontrib>Liang, Tsung-Jung</creatorcontrib><creatorcontrib>Chiang, Chia-Ling</creatorcontrib><creatorcontrib>Liang, Huei-Lung</creatorcontrib><creatorcontrib>Chen, I-Shu</creatorcontrib><creatorcontrib>Chen, Yu-Chia</creatorcontrib><creatorcontrib>Chang, Po-Ming</creatorcontrib><creatorcontrib>Chou, Nan-Hua</creatorcontrib><creatorcontrib>Wang, Being-Whey</creatorcontrib><title>Adjuvant hepatic arterial infusion chemotherapy is beneficial for selective patients with Hepatocellular carcinoma undergoing surgical treatment</title><title>International journal of surgery (London, England)</title><addtitle>Int J Surg</addtitle><description>Recurrence rate after curative surgical resection of Hepatocellular carcinoma (HCC) remains high. Postoperative hepatic arterial infusion chemotherapy (HAIC) has been suggested to improve survival. This study is to investigate the efficacy of HAIC in the patients with poor tumor factors such as vascular invasion or multiplicity.
From 2006 to 2014, 221 patients with HCC undergoing hepatectomy and pathologically staged as ≧ T2 (American Joint Committee on Cancer TNM staging system, 7th edition) were included. 61 patients received adjuvant HAIC with 5-fluorouracil, cisplatin, and epirubicin. 160 patients received surgery alone. The overall survival time (OST) and disease free survival time (DFST) were compared between the two groups.
In all patients, the multivariate analysis of survival data showed that resection margin less than 10 mm was the independent poor prognostic factors. The median OST and DFST between the HAIC and surgery alone groups were 56.4 vs. 56.9 months (p = 0.76), and 50.6 vs. 54.5 months (p = 0.905), respectively. There was no significant difference. For patients with multiple tumors and concomitantly microvascular invasion, the OST was better in the HAIC group (69.7 vs. 54.6 months, p < 0.05).
Based on the image and operative finding, we classified multiple HCC's into two types. Type A: multiple small nodules were close to each other or a huge tumor with several satellite nodules. Type B: two or more tumors scattering in separate segments. Our study showed that type A group benefits from adjuvant HAIC much more than type B. (the median OST in type A versus type B were 85.06 vs. 41.53 months, p = 0.0036).
The surgical outcome for the patients with multiple HCC's and vascular invasion was poor. Our study showed adjuvant HAIC was beneficial in these patients and formed the basis for further randomized controlled trials.
•HAIC provided benefit for HCC patients with microvascular invasion and selective multiple tumor after surgery.•HAIC is not suitable for every patients undergoing surgery.•Solitary HCC patients should not receive adjuvant HAIC, especially in non-HBV patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Carcinoma, Hepatocellular - drug therapy</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Chemotherapy, Adjuvant - methods</subject><subject>Cisplatin - administration & dosage</subject><subject>Disease-Free Survival</subject><subject>Epirubicin - administration & dosage</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Hepatectomy</subject><subject>Hepatic arterial infusion chemotherapy</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Infusions, Intra-Arterial</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple tumor</subject><subject>Neoplasm Staging</subject><subject>Patient Selection</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>1743-9191</issn><issn>1743-9159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtrJCEUhWXIMHn-gVkMLmfTHa1Ha0E2ISSTQCCbzFpsvXZbVGnHRw_5F_nJUTqTZeCCCud8XM9B6CclS0ro6nJc2jHmZUMoW5I69Bs6oaxrFwPth6PP-0CP0WmMIyEd4ZT_QMcNZw0feH-C3q71mPfSJbyFnUxWYRkSBCsnbJ3J0XqH1RZmn7YQ5O4V24jX4MBYVTXGBxxhApXsHnAFgEsR_7Npi-8r0CuYpjzJgJUMyjo_S5ydhrDx1m1wzGFjVQGlADLNxXyOvhs5Rbj4OM_Q37vb55v7xePTn4eb68eF6ghJC8rXnYGhKy_dMtVqqlbc0I7p1cAkZ5Qwxrhad33T9JS0jJnesIZIrQwzpG_P0O8Ddxf8S4aYxGxjXVY68DkKOhQjYQ2jRdocpCr4GAMYsQt2luFVUCJqE2IUtQlRmxCkTjX9-uDn9Qz60_I_-iK4Ogig_HJvIYioSnoKtA0lT6G9_Yr_Dut5njY</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Hsiao, Jui-Hu</creator><creator>Tsai, Cheng-Chung</creator><creator>Liang, Tsung-Jung</creator><creator>Chiang, Chia-Ling</creator><creator>Liang, Huei-Lung</creator><creator>Chen, I-Shu</creator><creator>Chen, Yu-Chia</creator><creator>Chang, Po-Ming</creator><creator>Chou, Nan-Hua</creator><creator>Wang, Being-Whey</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6417-0186</orcidid></search><sort><creationdate>201709</creationdate><title>Adjuvant hepatic arterial infusion chemotherapy is beneficial for selective patients with Hepatocellular carcinoma undergoing surgical treatment</title><author>Hsiao, Jui-Hu ; 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Postoperative hepatic arterial infusion chemotherapy (HAIC) has been suggested to improve survival. This study is to investigate the efficacy of HAIC in the patients with poor tumor factors such as vascular invasion or multiplicity.
From 2006 to 2014, 221 patients with HCC undergoing hepatectomy and pathologically staged as ≧ T2 (American Joint Committee on Cancer TNM staging system, 7th edition) were included. 61 patients received adjuvant HAIC with 5-fluorouracil, cisplatin, and epirubicin. 160 patients received surgery alone. The overall survival time (OST) and disease free survival time (DFST) were compared between the two groups.
In all patients, the multivariate analysis of survival data showed that resection margin less than 10 mm was the independent poor prognostic factors. The median OST and DFST between the HAIC and surgery alone groups were 56.4 vs. 56.9 months (p = 0.76), and 50.6 vs. 54.5 months (p = 0.905), respectively. There was no significant difference. For patients with multiple tumors and concomitantly microvascular invasion, the OST was better in the HAIC group (69.7 vs. 54.6 months, p < 0.05).
Based on the image and operative finding, we classified multiple HCC's into two types. Type A: multiple small nodules were close to each other or a huge tumor with several satellite nodules. Type B: two or more tumors scattering in separate segments. Our study showed that type A group benefits from adjuvant HAIC much more than type B. (the median OST in type A versus type B were 85.06 vs. 41.53 months, p = 0.0036).
The surgical outcome for the patients with multiple HCC's and vascular invasion was poor. Our study showed adjuvant HAIC was beneficial in these patients and formed the basis for further randomized controlled trials.
•HAIC provided benefit for HCC patients with microvascular invasion and selective multiple tumor after surgery.•HAIC is not suitable for every patients undergoing surgery.•Solitary HCC patients should not receive adjuvant HAIC, especially in non-HBV patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28728985</pmid><doi>10.1016/j.ijsu.2017.07.071</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6417-0186</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - administration & dosage Carcinoma, Hepatocellular - drug therapy Carcinoma, Hepatocellular - surgery Chemotherapy, Adjuvant - methods Cisplatin - administration & dosage Disease-Free Survival Epirubicin - administration & dosage Female Fluorouracil - administration & dosage Hepatectomy Hepatic arterial infusion chemotherapy Hepatocellular carcinoma Humans Infusions, Intra-Arterial Liver Neoplasms - drug therapy Liver Neoplasms - surgery Male Middle Aged Multiple tumor Neoplasm Staging Patient Selection Retrospective Studies Survival Survival Rate Treatment Outcome |
| title | Adjuvant hepatic arterial infusion chemotherapy is beneficial for selective patients with Hepatocellular carcinoma undergoing surgical treatment |
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