ArticleWorld journal of surgical oncology2025
Postoperative adjuvant transarterial chemoembolization prolongs overall survival in alpha-fetoprotein-negative hepatocellular carcinoma with bile duct tumor thrombosis: a long-term retrospective cohort study.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Postoperative Adjuvant Transcatheterarterial Chemoembolization Should Be Considered Selectively for Patients with Cytokeratin-19 Positive Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
- Transcatheter Arterial Chemoembolization May Be Selectively Indicated as Postoperative Adjuvant Therapy for Hepatocellular Carcinoma Patients with Microvascular Invasion.Journal of hepatocellular carcinoma · 2025Article
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11 authors.
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Abstract
backgroundHepatocellular carcinoma (HCC) with bile duct tumor thrombosis (BDTT) is a rare clinical condition with rapid disease progression and poor prognosis. This study aimed to evaluate the prognostic value of postoperative adjuvant transarterial chemoembolization (PA-TACE) among HCC-BDTT patients after radical resection (R0).
methodsBetween January 2002 and December 2010, 93 HCC-BDTT patients who underwent R0 resection were enrolled for a retrospective study, including 46 patients with PA-TACE and 47 patients without PA-TACE within two months postoperatively. The correlation between PA-TACE and the long-term prognosis of patients was analysed. Independent risk factors were identified by univariate and multivariate analysis.
resultsOverall, PA-TACE did not significantly improve disease-free survival (DFS) or overall survival (OS) in the entire cohort (median OS: 25 vs. 16 months, P = 0.106). However, alpha fetoprotein (AFP)-negative patients receiving PA-TACE demonstrated significantly prolonged DFS (5-year: 50.8% vs. 11.6%, P = 0.030) and OS (5-year: 64.0% vs. 26.3%, P = 0.005). AFP (HR = 3.79, 95% CI 2.06-6.98, P < 0.001) and ALP (HR = 2.12, 95% CI 1.11-4.06, P = 0.023) were independent risk factors for OS. PA-TACE showed no benefit in AFP-positive patients (5-year OS: 0% vs. 9.4%, P = 0.859). Elevated ALP (≥ 130 U/L) correlated with worse DFS (5-year: 3.1% vs. 19.6%, P = 0.027) and OS (5-year: 8.8% vs. 22.3%, P = 0.020).
conclusionPreoperative serum AFP and alkaline phosphatase were independent risk factors for evaluating the prognosis of HCC-BDTT. Postoperative prophylactic TACE can significantly prolong overall survival of HCC-BDTT in AFP-negative patients but not in AFP-positive cases, highlighting the need for tailored adjuvant therapies.
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