Transarterial chemoembolization combined with apatinib versus transarterial chemoembolization alone for hepatocellular carcinoma with macroscopic vascular invasion: A propensity score matching analysis.

CONTEXT

Macroscopic vascular invasion in hepatocellular carcinoma (HCC) remains challenging to treat.

AIMS

The aim of this study was to compare the efficacy of transarterial chemoembolization (TACE)-apatinib therapy with TACE treatment alone in HCC patients with macrovascular invasion, using propensity score matching (PSM).

SETTINGS AND DESIGN

Matched paired comparison between the TACE-apatinib and TACE alone group using 1:2 PSM was utilized.

SUBJECTS AND METHODS

Between 2013 and 2019, 378 patients receiving TACE-apatinib or TACE alone were included based on specific selection criteria.

STATISTICAL ANALYSIS USED

Multivariate Cox regression models were used to determine the independent prognostic factors for overall survival (OS).

RESULTS

Of the patients included, 40 (12.5%) received TACE-apatinib treatment and 280 (87.5%) received TACE alone. Tumor sizes of patients in the TACE-apatinib group were more frequently classified as small (<5 cm) compared to those in the TACE alone group (P = 0.021; mean: 8.6 cm vs. 10.2 cm). After 1:2 PSM, 40 pairs of HCC patients with well-matched covariates were selected from the two treatment groups. Patients in the TACE-apatinib group had higher OS rates than patients in the TACE alone group (P = 0.018). The median OS times were 18.2 and 8.5 months in the TACE-apatinib and TACE alone groups, respectively. The OS hazard ratio for the choice of TACE-apatinib treatment compared to TACE treatment alone was 0.50 (95% confidence interval: 0.28-0.90; P = 0.021).

CONCLUSIONS

TACE combined with apatinib may result in superior OS compared to TACE therapy alone for HCC patients with macrovascular invasion.