scholarly journals Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiao Ke ◽  
Lei Wang ◽  
Weimin Wu ◽  
Xinhui Huang ◽  
Ling Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Surgical Resection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Hepatic Artery Infusion ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

BackgroundTo systematically identify the long-term efficacy of postoperative adjuvant hepatic artery infusion chemotherapy (HAIC) for patients with hepatocellular carcinoma (HCC).MethodsPubMed, MedLine, Embase, the Cochrane Library, and Web of Science were searched to collect the eligible studies up to March 31, 2021, that compared the surgical resection (SR) versus SR+HAIC for HCC patients. The endpoints were overall survival (OS) rates and disease-free survival (DFS) rates, and the effect size was determined by hazard ratio (HR) with 95% CI.ResultsA total of 12 studies (two randomized controlled trials (RCTs) and 10 non-RCTs) including 1,333 patients were eligible for this meta-analysis. The pooled results showed that OS and DFS rates in the SR+HAIC group were both better than those in the SR alone group (HR = 0.56, 95% CI = 0.41–0.77, p < 0.001; HR = 0.66, 95% CI = 0.55–0.78, p < 0.001, respectively). Furthermore, the subgroup analysis showed that patients would benefit from SR+HAIC regardless of chemotherapy regimens and courses (all p < 0.05), and patients with microvascular or macrovascular invasion would also benefit more from SR+HAIC in terms of OS and DFS (all p < 0.05).ConclusionPostoperative adjuvant HAIC could improve the long-term prognosis of HCC patients, especially for those with microvascular or macrovascular invasion, regardless of chemotherapy regimens and courses, but it deserves further validation.

Hepatocellular carcinoma (HCC): Resection with adjuvant hepatic artery infusion chemotherapy (HAIC) versus resection alone—A systematic review and meta-analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 357-357
Author(s):  
Alexandra Moran ◽  
Lorena Flor Ramos ◽  
Omar Picado ◽  
Heather Stuart ◽  
Vikas Dudeja ◽  
...  
Keyword(s):  
Survival Time ◽  
Surgical Resection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Hepatic Artery Infusion ◽  
Female Ratio ◽  
Free Survival ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy ◽  
Disease Free

357 Background: HCC have a recurrence rate of up to 70% in 5 years after resection detrimentally lowering survival. The role of adjuvant HAIC in management of HCC in patients who are not candidates for transplantation is controversial. We aimed to evaluate overall and disease free survival in these patients. Methods: A comprehensive online search of MEDLINE, EMBASE, PubMed, SCOPUS and the Cochrane database was conducted (Jan 1994 - August 2016). Comparative studies including patients with HCC, who are not transplant candidates, undergoing surgical resection and adjuvant HAIC vs surgical resection alone were reviewed. Study quality was assessed using STROBE checklist. Pooled risk ratios and 95% confidence intervals (CI) for overall and disease-free survival at 1, 3 and 5 years were calculated. Results: Overall, 10 studies with 595 HCC patients were included; 283 underwent resection followed by HAIC and 312 underwent resection alone. Mean age was 61 ± 10.1 years with a male/female ratio of 6/1. Meta-analysis of all included studies showed better overall survival in patients undergoing resection followed by HAIC compared with resection alone at 1-YR (Average 90.1% vs 79.5%, RR:1.15, CI:1.07 – 1.24, p=0.095, NS), 3-YR (Average 72.1% vs 49.4%, RR:1.57, CI:1.34 – 1.77, p<0.01) and 5-YR (Average 51% vs 30.2%, RR:1.71, CI:1.33 – 2.20, p<0.01). Median survival time for the resection with HAIC group was 54.94 months compared to 31.5 months for the resection alone group. In addition, disease-free survival was better with HAIC at 1-YR (RR:1.36, CI:1.21 – 1.54, p<0.01), 3-YR (RR:1.59, CI:1.27 – 1.98, p<0.01) and 5-YR (RR:1.85, CI:132. – 2.61, p=0.011). The median disease-free survival time for the resection with HAIC group was 17.5 months compared to 7.35 months for the resection alone group. Subgroup analysis showed that this survival advantage was more significant in patients with tumors ≥7cm (p<0.05). Conclusions: Combination of HCC resection with HAIC improve overall and disease-free survival of patients with HCC who are not candidates for transplantation, especially in tumors ≥ 7cm.

scholarly journals Hepatic artery-infusion chemotherapy improved survival of hepatocellular carcinoma after radical hepatectomy

2017 ◽  
Vol Volume 10 ◽  
pp. 3001-3005 ◽  
Author(s):  
Min Feng ◽  
Chengwu Tang ◽  
Wenming Feng ◽  
Ying Bao ◽  
Yinyuan Zheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Hepatic Artery Infusion ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

scholarly journals Effects of Antiviral Therapy on HBV Reactivation and Survival in Hepatocellular Carcinoma Patients Undergoing Hepatic Artery Infusion Chemotherapy

2021 ◽  
Vol 10 ◽  
Author(s):  
Shousheng Liu ◽  
Jinfa Lai ◽  
Ning Lyu ◽  
Qiankun Xie ◽  
Huijiao Cao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Hepatic Artery ◽  
Primary Hepatocellular Carcinoma ◽  
Hepatic Artery Infusion ◽  
Hbv Reactivation ◽  
Antiviral Prophylaxis ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

BackgroundThis study aimed to investigate the influence of hepatic artery infusion chemotherapy (HAIC) on hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) positive patients with primary hepatocellular carcinoma (HCC) as well as evaluate the role of antiviral prophylaxis in these patients.MethodsWe enrolled 170 HBsAg-positive advanced HCC patients receiving HAIC using mFOLFOX regimen, of which 137 patients received antiviral prophylaxis. Risk factors for HBV reactivation were analyzed. The overall survival (OS) from the first application of HAIC were compared between antiviral and non-antiviral groups.ResultsA total of 25 patients (14.7%) developed HBV reactivation after HAIC, of which 16 patients received antiviral treatment and nine patients did not. The incidence of HBV reactivation was 11.7% (16/137) in antiviral group and 27.3% (9/33) in non-antiviral group respectively. No antiviral prophylactic was the only significant risk factor for HBV reactivation (OR=12.35, 95% confidence interval (CI) 4.35–33.33, p&lt;0.001). Patients in antiviral group received more cycles of HAIC compared with non-antiviral group (3.11 ± 1.69 vs 1.75 ± 1.18, p&lt;0.05) at the time of HBV reactivated. Seven of the 25 HBV reactivation patients developed hepatitis. OS in antiviral group was significantly longer than that of non-antiviral group (median 16.46 vs 10.68 months; HR=0.57; 95% CI, 0.36–0.91; p&lt;0.05).ConclusionsHBV reactivation is more prone to occur in the HBsAg-positive HCC patients undergoing HAIC without antiviral prophylaxis. Regular monitoring of HBV DNA and antiviral prophylaxis are suggested to prevent HBV reactivation as well as prolong the OS of these patients.Name of the Trial RegisterHAIC Using Oxaliplatin Plus Fluorouracil/Leucovorin for Patients with Locally Advanced HCC.Clinical Trial Registrationhttps://www.clinicaltrials.gov/, identifier NCT 02436044

scholarly journals Revisiting Hepatic Artery Infusion Chemotherapy in the Treatment of Advanced Hepatocellular Carcinoma

2021 ◽  
Vol 22 (23) ◽  
pp. 12880
Author(s):  
Ching-Tso Chen ◽  
Tsung-Hao Liu ◽  
Yu-Yun Shao ◽  
Kao-Lang Liu ◽  
Po-Chin Liang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Treatment Efficacy ◽  
Tumor Burden ◽  
Hepatic Artery Infusion ◽  
Advanced Hepatocellular Carcinoma ◽  
Clinical Value ◽  
Infusion Chemotherapy ◽  
Vein Thrombosis ◽  
Hepatic Artery Infusion Chemotherapy

Hepatic artery infusion chemotherapy (HAIC) is a well-established and common treatment for advanced hepatocellular carcinoma (HCC), particularly in East Asia. However, HAIC is not recognized internationally. Although several trials have demonstrated the safety and efficacy of HAIC, evidence corroborating its overall survival (OS) benefits compared with standard treatments is insufficient. Nevertheless, HAIC may provide prominent benefits in selected patients such as patients with portal vein thrombosis or high intrahepatic tumor burden. Moreover, HAIC has been combined with several therapeutic agents and modalities, including interferon-alpha, multikinase inhibitors, radiation therapy, and immunotherapy, to augment its treatment efficacy. Most of these combinations appeared to increase overall response rates compared with HAIC alone, but results regarding OS are inconclusive. Two prospective randomized controlled trials comparing HAIC plus sorafenib with sorafenib alone have reported conflicting results, necessitating further research. As immunotherapy-based combinations became the mainstream treatments for advanced HCC, HAIC plus immunotherapy-based treatments also showed encouraging preliminary results. The trials of HAIC were heterogeneous in terms of patient selection, chemotherapy regimens and doses, HAIC combination agent selections, and HAIC technical protocols. These heterogeneities may contribute to differences in treatment efficacy, thus increasing the difficulty of interpreting trial results. We propose that future trials of HAIC standardize these key factors to reveal the clinical value of HAIC-based treatments for HCC.

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