Gamma knife radiosurgery versus transcatheter arterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus: a propensity score matching study

Su, Ke; Gu, Tao; Xu, Ke; Wang, Jing; Liao, Hongfei; Li, Xueting; Wen, Lianbin; Song, Yanqiong; Zhong, Jiaqi; He, Bingsheng; Liu, Xin; He, Jié; Liu, Yanlin; Li, Qi; Feng, Xunjie; Chen, Siyu; Yang, Binbin; Huang, Weihong; Jin, Hongping; Luo, Xiaotong; Hu, Teng; Chen, Jiali; Wu, Zhenying; Lu, Simin; Zhang, Jianwen; Rao, Mingyue; Xie, Yunchuan; Zhu, Xiaoning; Chen, Lan; Li, Bo; Su, Song; Yang, Xiaoli; Wang, Juan; Zeng, Hao; Wang, Pan; Yan, Min; Chen, Xiaojing; He, Kun; Han, Yunwei

doi:10.1007/s12072-022-10339-2

Cited by 18 publications

(20 citation statements)

References 36 publications

(48 reference statements)

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“…In addition, most of the patients we studied at our hospitals were treated with GRK as the RT modality. Treatments of the non-RT group included TACE, and our results showed that RT had superior e cacy to TACE and other treatments in this group of patients, which is consistent with ndings from the previous study by Su et al 17 .…”

Section: Discussionsupporting

confidence: 92%

“…In addition, Lu et al rst reported that the combination of TACE plus GKR was well tolerated and produced overall survival (OS) bene ts in HCC patients with portal vein tumor thrombosis (PVTT) 13 . And in our previous study, Su et al proved that GKR had better OS compared with TACE in HCC with PVTT (17.2 vs. 8.0 months, p < 0.001) 17 . RT is an evolving technique for HCC, and it should receive more attention.…”

Section: Introductionmentioning

confidence: 82%

“…4e). However, in the analysis of chemotherapy combined with RT, the situation appeared to be different, with no signi cant difference in mOS between those receiving one treatment modality alone (either RT or chemotherapy) or both modalities (RT alone: 16 months [95% CI [15][16][17][18], chemotherapy alone: 16 months [95% CI [14][15][16][17][18], RT + chemotherapy: 17 months [95% CI [15][16][17][18]), but mOS was much lower in patients who did not receive either treatment (3 months, 95% CI 2-4, p < 0.05) (Fig. 4f).…”

Section: Survival Outcome After Psm From Seer Databasementioning

confidence: 99%

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Survival benefit of radiotherapy in patients with inoperable hepatocellular carcinoma: a propensity score matching study

Zeng

Chen

et al. 2022

Preprint

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Background In recent years, with the development of radiotherapy (RT), several studies have shown that RT can significantly prolong the survival of hepatocellular carcinoma (HCC) patients. As a noninvasive treatment option, the application of RT for HCC is gradually gaining attention. Patients and methods: This retrospective study included data from 13,878 patients with HCC collected from the SEER database between 2000 and 2019 and 325 patients with HCC treated in three tertiary hospitals in China between 2015 and 2021. Patient data were divided into RT and non-RT groups based on whether the patients had received RT. Propensity score matching (PSM) analysis was used to minimize the deviation between the RT and non-RT groups, and the Kaplan-Meier method and Cox proportional hazard model were used to assess the efficacy of receiving RT. Results The median overall survival (mOS) was significantly longer in the RT group than in the non-RT group for SEER data (16 months vs 9 months, p < 0.01). Similarly, the survival benefit was more significant in the RT vs non-RT groups of patients at our hospitals (34.1 months vs 15.4 months, p < 0.01). In addition, multivariate Cox analysis showed that factors such as tumor (T) stage, patient age, tumor grade, serum AFP level and chemotherapy also affected patient survival. Subgroup analysis of these factors showed that RT was effective in prolonging patient survival in different populations. Conclusion RT significantly improves the survival time of patients with inoperable HCC, providing a basis for selecting HCC patients who will benefit from RT.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 82%

Section: Survival Outcome After Psm From Seer Databasementioning

confidence: 99%

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Survival benefit of radiotherapy in patients with inoperable hepatocellular carcinoma: a propensity score matching study

Zeng

Chen

et al. 2022

Preprint

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“… 34 In addition, Su et al confirmed that gamma knife radiosurgery has a superior OS compared to TACE in the treatment of PVTT-HCC. 35 Predicting the prognosis of HCC patients remains a formidable obstacle, despite the widespread use of numerous treatment methods in clinical practice. In our subgroup analysis based on various treatment modes, the ALP and LDH groups with low expression and the ALP and LDH groups with high expression exhibited superior OS.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Lactate Dehydrogenase and Alkaline Phosphatase as Predictive Biomarkers in the Prognosis of Hepatocellular Carcinoma and Development of a New Nomogram

Su¹,

Huang²,

Li³

et al. 2023

JHC

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Background Tumor proliferation is frequently accompanied by aberrant enzyme production. We aim to investigate the potential predictive value of both plasma alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in patients with HCC and to develop a nomogram to assess the prognosis of HCC. Methods The trial involved 2327 patients between May 2015 and March 2022. Within 7 days of enrollment, the levels of ALP and LDH were measured, and their association with survival was assessed. And we had developed and validated a new nomogram based on ALD and ALP. Results Using X-tile software, the optimal cut-off values were determined to be ALP = 172 U/L and LDH = 241 U/L. The high ALP (≥ 172), LDH (≥ 241), and ALP/LDH (≥ 0.91) groups had lower median overall survival (mOS) than low ALP (< 172), LDH (< 241), and ALP/LDH (< 0.91) groups (all p < 0.001). In addition, elevated ALP and LDH levels are independent negative prognostic indicators. Moreover, we established that the area under the curve (AUC) values of the predicted 1-, 2-, and 3-year survival rates of receiver operating characteristic curve (ROC) based on the nomogram were 0.79, 0.77, and 0.74, respectively. In addition, the calibration curves and decision curve analyses (DCA) demonstrated that this model possessed strong predictive capability. Conclusion ALP, LDH and ALP/LDH can be employed as biomarkers for predicting the prognosis of HCC. Furthermore, the nomograph based on ALH and ALP demonstrates good HCC prediction performance. For HCC patients with high ALH or ALP or ALP/LDH, close surveillance program and adjuvant therapy should be considered.

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“…A high probability of tumor transfer via the portal vein before liver resection could lead to a high likelihood of persistent tumor cells after LR in HCC patients with PVI, HCC complicated with MVI is prone to have residual cancer cells after hepatectomy, making the chemotherapy more evident. It was reported that gamma knife radiosurgery and transcatheter arterial chemoembolization had different survival effect for patients with HCC depending on the type of portal vein tumor thrombus (PVTT) [ 33 ]. Hence, it would be better to evaluate the efficacy of HAIC for HCC patients based on the type of PVTT in further research.…”

Section: Discussionmentioning

confidence: 99%

Does adjuvant hepatic artery infusion chemotherapy improve patient outcomes for hepatocellular carcinoma following liver resection? A meta-analysis

Zheng

Lin

et al. 2023

World J Surg Onc

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Background Adjuvant hepatic artery infusion chemotherapy (HAIC) has been shown to be beneficial to the patient outcomes in hepatocellular carcinoma (HCC). Methods Randomized controlled trials (RCTs) and non-RCTs were identified from six databases up to January 26, 2023. Patient outcomes were assessed using overall survival (OS) and disease-free survival (DFS). Data were presented as hazard ratios (HR, 95% confidence intervals, or CIs). Results The present systematic review included 2 RCTs and 9 non-RCTs with a total of 1290 cases. Adjuvant HAIC improved OS (HR of 0.69; 95% CI of 0.56–0.84; p < 0.01) and DFS (HR of 0.64; 95% CI of 0.49–0.83; p < 0.01). Subgroup analysis showed that HCC patients with portal vein invasion (PVI) or microvascular invasion (MVI) benefit from adjuvant HAIC in terms of OS ((HR of 0.43; 95% CI of 0.19–0.95; p < 0.01) and (HR of 0.43; 95% CI of 0.19–0.95; p = 0.0373), respectively) and DFS ((HR of 0.38; 95% CI of 0.21–0.69; p < 0.01) and (HR of 0.73; 95% CI of 0.60–0.88; p = 0.0125), respectively). Adjuvant HAIC with the oxaliplatin-based approach significantly improved OS (HR of 0.60; 95% CI of 0.36–0.84; p = 0.02) and (HR of 0.59; 95% CI of 0.43–0.75; p < 0.01), respectively). Conclusion This meta-analysis demonstrated that postoperative adjuvant HAIC was beneficial in HCC patients with PVI and MVI. It remains unclear whether HAIC can improve the survival outcome in all HCC patients after hepatic resection.

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Gamma knife radiosurgery versus transcatheter arterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus: a propensity score matching study

Cited by 18 publications

References 36 publications

Survival benefit of radiotherapy in patients with inoperable hepatocellular carcinoma: a propensity score matching study

Survival benefit of radiotherapy in patients with inoperable hepatocellular carcinoma: a propensity score matching study

Evaluation of Lactate Dehydrogenase and Alkaline Phosphatase as Predictive Biomarkers in the Prognosis of Hepatocellular Carcinoma and Development of a New Nomogram

Does adjuvant hepatic artery infusion chemotherapy improve patient outcomes for hepatocellular carcinoma following liver resection? A meta-analysis

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