Prognosis of TACE combined with sorafenib in hepatocellular carcinoma patients with microvascular invasion: A retrospective cohort study

Abstract

Abstract Purpose Transcatheter arterial chemoembolization (TACE) and sorafenib each has shown therapeutic effects in patients with hepatocellular carcinoma (HCC) and microvascular invasion (MVI). The present study evaluated the feasibility of postoperative TACE combined with sorafenib in HCC patients with MVI and assessed the optimal indications for postoperative TACE treatment. Patients and methods: The present study included 217 HCC patients who underwent radical resection from April 2017 to April 2020 and whose postoperative pathological report showed MVI. Patients were treated with TACE, TACE plus sorafenib, of neither (control group). The primary endpoints were overall survival (OS) and disease-free survival (DFS). Results Patients treated with TACE plus sorafenib had higher 1-year (96.4% vs. 84.9%) and 2-year (91.6% vs. 68.9%) OS rates than patients treated with TACE alone. Median OS was significantly longer in patients treated with TACE plus sorafenib (44.6 months; 95% confidence interval [CI ] 40.81–48.4 months) than with TACE alone (39 months; 95% CI 30.2–48.3 months; (p = 0.025). Cox proportional hazard model showed that factors associated with a higher risk of death after treatment included maximum tumor diameter of tumor (hazard ratio [HR] = 6.783, p = 0.012), number of TACE sessions (HR = 0.284, p = 0.01) and liver cirrhosis (HR = 6.446, p = 0.002). Conclusion Compared with TACE alone, TACE plus sorafenib significantly prolonged OS in patients with HCC and MVI. Factors associated with improved prognosis included maximum tumor diameter < 7 cm and more than three TACE sessions.