Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study
BackgroundHepatocellular carcinoma (HCC) is commonly treated with transarterial chemoembolization (TACE) in intermediate stages. Existing international definitions of TACE refractoriness may not fully suit Chinese patients. The Chinese College of Interventionalists (CCI) proposed a tailored definiti...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1483949/full |
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| author | Qinxue Sun Ziliang Wu Xi Yin Feng Li Ri Liu |
| author_facet | Qinxue Sun Ziliang Wu Xi Yin Feng Li Ri Liu |
| author_sort | Qinxue Sun |
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| description | BackgroundHepatocellular carcinoma (HCC) is commonly treated with transarterial chemoembolization (TACE) in intermediate stages. Existing international definitions of TACE refractoriness may not fully suit Chinese patients. The Chinese College of Interventionalists (CCI) proposed a tailored definition, but its impact on HCC prognosis is still limited.MethodsThis study included 844 patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC from a multicenter dataset. Propensity score matching (PSM) was used to minimize baseline differences between the TACE-Refractoriness (n = 54) and TACE-Non-Refractoriness (n = 108) groups. Kaplan-Meier survival analysis and multivariate Cox regression models were performed to evaluate the association between TACE-Refractoriness and OS. Subgroup analyses were conducted across key clinical and tumor-related characteristics.ResultsKaplan-Meier survival analysis indicated that patients classified as TACE-Refractory exhibited significantly shorter OS compared to those categorized as TACE-Non-Refractory in both the original and matched cohorts (P < 0.001). Furthermore, multivariate analysis identified TACE refractoriness as a significant predictor of poorer OS, yielding an adjusted hazard ratio (HR) of 5.96 (95% CI: 3.39-10.5, P < 0.001). Subgroup analysis further demonstrated the robustness of these findings across subgroups, except in female patients (HR = 3.0, 95% CI: 0.72–12.52; P=0.131).ConclusionsCCI-defined TACE refractoriness is associated with reduced OS in patients with BCLC stage B HCC undergoing TACE. |
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| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Oncology |
| spelling | doaj-art-bd32d39385e84ad78d28c0541143b8422025-01-20T05:23:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011410.3389/fonc.2024.14839491483949Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort studyQinxue Sun0Ziliang Wu1Xi Yin2Feng Li3Ri Liu4Department of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital (The Affiliated LiHuiLi Hospital of Ningbo University), Ningbo, Zhejiang, ChinaDepartment of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital (The Affiliated LiHuiLi Hospital of Ningbo University), Ningbo, Zhejiang, ChinaDepartment of Radiology, Mental Health Institute of Inner Mongolia Autonomous Region (The Third Hospital of Inner Mongolia Autonomous Region, Brain Hospital of Inner Mongolia Autonomous Region), Hohhot, Inner Mongolia, ChinaDepartment of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital (The Affiliated LiHuiLi Hospital of Ningbo University), Ningbo, Zhejiang, ChinaDepartment of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital (The Affiliated LiHuiLi Hospital of Ningbo University), Ningbo, Zhejiang, ChinaBackgroundHepatocellular carcinoma (HCC) is commonly treated with transarterial chemoembolization (TACE) in intermediate stages. Existing international definitions of TACE refractoriness may not fully suit Chinese patients. The Chinese College of Interventionalists (CCI) proposed a tailored definition, but its impact on HCC prognosis is still limited.MethodsThis study included 844 patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC from a multicenter dataset. Propensity score matching (PSM) was used to minimize baseline differences between the TACE-Refractoriness (n = 54) and TACE-Non-Refractoriness (n = 108) groups. Kaplan-Meier survival analysis and multivariate Cox regression models were performed to evaluate the association between TACE-Refractoriness and OS. Subgroup analyses were conducted across key clinical and tumor-related characteristics.ResultsKaplan-Meier survival analysis indicated that patients classified as TACE-Refractory exhibited significantly shorter OS compared to those categorized as TACE-Non-Refractory in both the original and matched cohorts (P < 0.001). Furthermore, multivariate analysis identified TACE refractoriness as a significant predictor of poorer OS, yielding an adjusted hazard ratio (HR) of 5.96 (95% CI: 3.39-10.5, P < 0.001). Subgroup analysis further demonstrated the robustness of these findings across subgroups, except in female patients (HR = 3.0, 95% CI: 0.72–12.52; P=0.131).ConclusionsCCI-defined TACE refractoriness is associated with reduced OS in patients with BCLC stage B HCC undergoing TACE.https://www.frontiersin.org/articles/10.3389/fonc.2024.1483949/fullhepatocellular carcinomatransarterial chemoembolizationTACE refractorinessoverall survivalpropensity score matching |
| spellingShingle | Qinxue Sun Ziliang Wu Xi Yin Feng Li Ri Liu Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study Frontiers in Oncology hepatocellular carcinoma transarterial chemoembolization TACE refractoriness overall survival propensity score matching |
| title | Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study |
| title_full | Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study |
| title_fullStr | Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study |
| title_full_unstemmed | Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study |
| title_short | Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study |
| title_sort | association between transarterial chemoembolization refractoriness and prognosis in chinese patients with hepatocellular carcinoma a large retrospective cohort study |
| topic | hepatocellular carcinoma transarterial chemoembolization TACE refractoriness overall survival propensity score matching |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1483949/full |
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