ArticleBMC medicine2025
Radiological characteristics for guiding intra-arterial therapy in intermediate-stage hepatocellular carcinoma.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate and contrast the efficacy and safety of trans-arterial chemoembolization (TACE) versus hepatic arterial infusion chemotherapy (HAIC) for intermediate-stage hepatocellular carcinoma (HCC) based on varying radiologic patterns.
methodsA retrospective study identified 3,060 consecutive patients with intermediate-stage HCC who underwent initial TACE or HAIC between January 2009 and December 2022. HCC radiological features were categorized into pseudo-capsulated, pseudocapsule breakthrough, confluent multinodular, and infiltrative types. The propensity score matching (PSM) method was employed to minimize selection bias. The progression-free survival (PFS) was compared using the Kaplan-Meier method with the log-rank test. Independent prognostic factors were assessed using a forward stepwise Cox regression model in multivariable analyses.
resultsAfter propensity score matching, each group in the infiltrative HCC cohort included 237 patients, while the non-infiltrative HCC cohort comprised 262 patients per group. Notably, radiologic patterns were shown with statistical significance in three groups with different tumor burden (P < 0.001). Pseudo-capsulated type was dominant (55.6%) in < 6 cohorts, and infiltrative type was dominant (49.5%) in > 12 cohorts. A higher PFS was observed in the HAIC group compared to the TACE group in the infiltrative HCC cohort (P < 0.001), but comparable PFS was found between the two groups in the non-infiltrative HCC cohort (P = 0.532). In the multivariate analysis, both tumor burden and radiologic morphology showed significant associations with PFS.
conclusionsHAIC showed favorable outcomes in infiltrative HCC and might warrant further consideration in treatment planning.
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