Mei Jie, Li Shao-Hua, Wang Qiao-Xuan, Lu Liang-He, Ling Yi-Hong, Zou Jing-Wen, Lin Wen-Ping, Wen Yu-Hua, Wei Wei, Guo Rong-Ping
Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Guangzhou, China.
Front Oncol. 2020 May 5;10:573. doi: 10.3389/fonc.2020.00573. eCollection 2020.
Macroscopic vascular invasion (MVI) commonly occurs in patients with advanced hepatocellular carcinoma (HCC) for which resection and sorafenib are the common therapies prescribed. Here, we aimed to compare the survival outcomes of these two therapies in HCC patients with MVI. In total, 496 patients diagnosed with HCC and MVI without extrahepatic metastasis, treated with resection (resection-based group, = 388) and sorafenib (sorafenib-based group, = 108) were included in this study. A one-to-one propensity score-matching analysis (PSM) was performed to minimize the effect of potential confounders. The median OS in the resection- and sorafenib-based group was 20.7 months (95% CI: 16.9-24.5) and 11.6 months (95% CI: 8.4-14.9) ( < 0.001), respectively. The median PFS was 4.7 months (95% CI: 3.8-5.5) in the resection-based group and 4.4 months (95% CI: 3.6-5.2) in the sorafenib-based group ( < 0.001). After PSM, 72 patients from each group were matched. The median OS was 27.2 months (95% CI: 16.4-38.0) in the resection-based group and 13.0 months (95% CI: 9.6-16.3) in the sorafenib-based group ( < 0.001). The median PFS was 5.3 months (95% CI: 3.2-7.4) in the resection-based group and 4.8 months (95% CI: 3.6-6.0) in the sorafenib-based group ( = 0.061). Findings from this study showed that, compared with sorafenib-based treatment, surgical resection might be associated with better survival benefits to HCC patients with MVI.
宏观血管侵犯（MVI）常见于晚期肝细胞癌（HCC）患者，对于这类患者，常见的治疗方法是手术切除和使用索拉非尼。在此，我们旨在比较这两种治疗方法对伴有MVI的HCC患者的生存结局。本研究共纳入496例诊断为HCC且伴有MVI、无肝外转移的患者，这些患者接受了手术切除（手术切除组，n = 388）或索拉非尼治疗（索拉非尼组，n = 108）。进行了一对一倾向评分匹配分析（PSM）以尽量减少潜在混杂因素的影响。手术切除组和索拉非尼组的中位总生存期分别为20.7个月（95%CI：16.9 - 24.5）和11.6个月（95%CI：8.4 - 14.9）（P < 0.001）。手术切除组的中位无进展生存期为4.7个月（95%CI：3.8 - 5.5），索拉非尼组为4.4个月（95%CI：3.6 - 5.2）（P < 0.001）。PSM后，每组匹配了72例患者。手术切除组的中位总生存期为27.2个月（95%CI：16.4 - 38.0），索拉非尼组为13.0个月（95%CI：9.6 - 16.3）（P < 0.001）。手术切除组的中位无进展生存期为5.3个月（95%CI：3.2 - 7.4），索拉非尼组为4.8个月（95%CI：3.6 - 6.0）（P = 0.061）。本研究结果表明，与索拉非尼治疗相比，手术切除可能给伴有MVI的HCC患者带来更好的生存获益。
