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05-02-2024 | Hepatocellular Carcinoma | Hepatobiliary Tumors

Outcomes of Salvage Surgery Versus Non-Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma After Conversion Therapy with Transcatheter Arterial Chemoembolization Combined with Lenvatinib Plus Anti-PD-1 Antibody: A Multicenter Retrospective Study

Authors: Jun-Yi Wu, MD, PhD, Jia-Yi Wu, MD, Yang-Kai Fu, MD, Xiang-Ye Ou, MD, Shu-Qun Li, MD, Zhi-Bo Zhang, MD, Jian-Yin Zhou, MD, Bin Li, MD, Shuang-Jia Wang, MD, Yu-Feng Chen, MD, Mao-Lin Yan, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2024

Abstract

Background

Combination treatment with transcatheter arterial chemoembolization (TACE), lenvatinib, and anti-programmed death-1 (anti-PD-1) antibodies (triple therapy) has a high rate of tumor response and converted resection for initially unresectable hepatocellular carcinoma (uHCC) patients. This study aimed to assess the outcomes of salvage surgery in uHCC patients after conversion therapy with triple therapy.

Methods

uHCC patients who met the criteria for hepatectomy after receiving triple therapy as first-line treatment were eligible for inclusion in this study. The overall survival (OS) and progression-free survival (PFS) rates in patients who received salvage surgery (SR group) and those who did not (non-SR group) were compared.

Results

Of the 144 patients assessed, 91 patients underwent salvage surgery and 53 did not. The OS rates in the SR group were significantly better than those in the non-SR group. The 1- and 2-year OS rates in the SR group were 92.0% and 79.9%, respectively, whereas those in the non-SR group were 85.5% and 39.6 %, respectively (p = 0.007); however, there was no significant difference in the PFS rates. Upon further stratification, OS and PFS were significantly better in the SR group than in the non-SR group in patients who were assessed as partial responses (PR), while there was no significant difference in patients who were assessed as complete response (CR).

Conclusions

Salvage surgery is recommended and is associated with a favorable prognosis for uHCC patients who were assessed as PR after conversion therapy, however it may not be necessary for uHCC if CR was achieved.

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Title: Outcomes of Salvage Surgery Versus Non-Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma After Conversion Therapy with Transcatheter Arterial Chemoembolization Combined with Lenvatinib Plus Anti-PD-1 Antibody: A Multicenter Retrospective Study
Authors: Jun-Yi Wu, MD, PhD
Jia-Yi Wu, MD
Yang-Kai Fu, MD
Xiang-Ye Ou, MD
Shu-Qun Li, MD
Zhi-Bo Zhang, MD
Jian-Yin Zhou, MD
Bin Li, MD
Shuang-Jia Wang, MD
Yu-Feng Chen, MD
Mao-Lin Yan, MD, PhD
Publication date: 05-02-2024
Publisher: Springer International Publishing
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Lenvatinib
Published in: Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-14944-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes of Salvage Surgery Versus Non-Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma After Conversion Therapy with Transcatheter Arterial Chemoembolization Combined with Lenvatinib Plus Anti-PD-1 Antibody: A Multicenter Retrospective Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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