Hepatic Surgery Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430000, Hubei, China.
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Eur J Surg Oncol. 2023 Dec;49(12):107106. doi: 10.1016/j.ejso.2023.107106. Epub 2023 Sep 30.
High rate of recurrence impaired the prognosis of hepatocellular carcinoma (HCC) after surgery. We aimed to explore the safety and efficacy of neoadjuvant drug-eluting bead transarterial chemoembolization (D-TACE) and tislelizumab therapy for resectable or borderline resectable HCC.
41 HCC patients received neoadjuvant therapy and surgery were respectively enrolled. The safety and efficacy of the neoadjuvant therapy were assessed. The prognosis was evaluated and compared with that of 41 matched HCC patients who received surgery alone.
36 (87.8%) patients had adverse events (AEs) and only one patient had a grade 3/4 of ALT elevated. All patients performed surgery successfully and no severe postoperative complications occurred. The objective response rate (ORR) was 56.1% and 87.8% based on RECIST 1.1 and mRECIST, respectively. 15 (36.6%) patients had radiological complete tumor necrosis and the disease control rate (DCR) was 100%. The pathological complete response (pCR) and major pathological response (MPR) was 13 (31.7%) and 18 (43.9%), respectively. The incidence of microvascular invasion (MVI) was 4.9% in neoadjuvant therapy patients, compared with 64.9% before propensity score matching (PSM) and 60.9% after PSM for surgery alone patients. Neoadjuvant therapy patients had a significant better prognosis than surgery alone patients (recurrence-free survival p = 0.041, overall survival p = 0.006).
Our preliminary results suggest the neoadjuvant D-TACE and tislelizumab therapy is safe and benefit to the pathological results and prognosis for patients with resectable or borderline resectable HCC.
高复发率影响了肝癌（HCC）手术后的预后。我们旨在探讨新辅助载药微球动脉化疗栓塞（D-TACE）联合替雷利珠单抗治疗可切除或边界可切除 HCC 的安全性和有效性。
分别纳入 41 例接受新辅助治疗和手术的 HCC 患者。评估新辅助治疗的安全性和有效性。并与 41 例单纯手术的 HCC 患者的预后进行评估和比较。
36 例（87.8%）患者出现不良事件（AE），仅 1 例出现 3/4 级 ALT 升高。所有患者均成功手术，无严重术后并发症。根据 RECIST 1.1 和 mRECIST，客观缓解率（ORR）分别为 56.1%和 87.8%。15 例（36.6%）患者出现影像学完全肿瘤坏死，疾病控制率（DCR）为 100%。病理完全缓解（pCR）和主要病理缓解（MPR）分别为 13 例（31.7%）和 18 例（43.9%）。新辅助治疗患者的微血管侵犯（MVI）发生率为 4.9%，而倾向性评分匹配（PSM）前为 64.9%，单纯手术患者为 60.9%。新辅助治疗患者的无复发生存率（p=0.041）和总生存率（p=0.006）均明显优于单纯手术患者。
我们的初步结果表明，新辅助 D-TACE 联合替雷利珠单抗治疗可切除或边界可切除 HCC 患者安全有效，可改善病理结果和预后。
