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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1483949

Association between Transarterial Chemoembolization Refractoriness and Prognosis in Chinese Patients with Hepatocellular Carcinoma: A Large Retrospective Cohort Study

Provisionally accepted
Qinxue Sun Qinxue Sun 1Ziliang Wu Ziliang Wu 1Xi Yin Xi Yin 2Feng Li Feng Li 1Ri Liu Ri Liu 1*
  • 1 Department of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital, Ningbo, China
  • 2 Department of Radiology, Mental Health Institute of Inner Mongolia Autonomous Region (The Third Hospital of Inner Mongolia Autonomous Region), Hohot, China

The final, formatted version of the article will be published soon.

    Background: Hepatocellular carcinoma (HCC) is commonly treated with transarterial chemoembolization (TACE) in intermediate stages. Existing international definitions of TACE refractoriness may not fully suit Chinese patients. The Chinese College of Interventionalists (CCI) proposed a tailored definition, but its impact on HCC prognosis is still limited.Methods: This study included 844 patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC from a multicenter dataset. Propensity score matching (PSM) was used to minimize baseline differences between the TACE-Refractoriness (n = 54) and TACE-Non-Refractoriness (n = 108) groups. Kaplan-Meier survival analysis and multivariate Cox regression models were performed to evaluate the association between TACE-Refractoriness and OS. Subgroup analyses were conducted across key clinical and tumor-related characteristics.Results: Kaplan-Meier survival analysis indicated that patients classified as TACE-Refractory exhibited significantly shorter OS compared to those categorized as TACE-Non-Refractory in both the original and matched cohorts (P < 0.001). Furthermore, multivariate analysis identified TACE refractoriness as a significant predictor of poorer OS, yielding an adjusted hazard ratio (HR) of 5.96 (95% CI: 3.39-10.5, P < 0.001). Subgroup analysis further demonstrated the robustness of these findings across subgroups, except in female patients (HR = 3.0, 95% CI: 0.72-12.52; P=0.131).Conclusions: CCI-defined TACE refractoriness is associated with reduced OS in patients with BCLC stage B HCC undergoing TACE.

    Keywords: Hepatocellular Carcinoma, Transarterial chemoembolization, TACE refractoriness, overall survival, Propensity score matching

    Received: 20 Aug 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Sun, Wu, Yin, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ri Liu, Department of Interventional Radiology, Ningbo Medical Center LiHuiLi Hospital, Ningbo, China

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