Neoadjuvant hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin for resectable single large hepatocellular carcinoma.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-05-12 DOI:10.1097/JS9.0000000000002437

Zili Hu, Min Deng, Yizhen Fu, Zhongguo Zhou, Huanwei Chen, Minshan Chen, Yaojun Zhang

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引用次数: 0

Abstract

Background and aims: Patients diagnosed with single large hepatocellular carcinoma (HCC) often face a daunting prognosis and pose a treatment challenge. In this study, we aimed to evaluate the effectiveness of neoadjuvant hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil, and leucovorin (FOLFOX) in patients with single large HCC.

Methods: 397 patients with resectable single, ≥7 cm HCC from three centers in China between January 2016 and December 2021 were included, 268 patients underwent hepatectomy alone and 129 patients underwent neoadjuvant HAIC. The log-rank test was used to compare the overall survival (OS) and disease-free survival (DFS) by intension-to-treat analysis between the two groups.

Results: The 1-, 3-, and 5-year OS rates were 83.3%, 62.9%, and 53.8% in the surgery alone group, and 97.5%, 80.7%, and 64.7% in the neoadjuvant HAIC group. The 1-, 3-, and 5-year DFS rates were 48.8%, 32.5%, and 26.2% in the surgery alone group, and 71.5%, 61.7%, and 59.5% in the neoadjuvant HAIC group. The neoadjuvant HAIC group showed significantly longer OS (hazard ratio [HR], 0.506; 95% confidence interval [CI], 0.347-0.734; P < 0.001) and DFS (HR, 0.466; 95% CI, 0.357-0.609; P < 0.001) than the surgery alone group. There was no HAIC-related death in the neoadjuvant HAIC group.

Conclusions: Neoadjuvant FOLFOX-HAIC significantly improved the OS and DFS with acceptable toxicities in HCC patients with resectable single, ≥7 cm tumor.

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新辅助肝动脉输注奥沙利铂、氟尿嘧啶和亚叶酸素治疗可切除的单个大肝癌。

背景和目的：单发大肝细胞癌（HCC）患者往往面临着令人生畏的预后和治疗挑战。在这项研究中，我们旨在评估奥沙利铂、氟尿嘧啶和亚叶酸钙（FOLFOX）联合新辅助肝动脉输注化疗（HAIC）在单个大肝癌患者中的有效性。方法：纳入2016年1月至2021年12月来自中国三个中心的397例可切除的单个≥7 cm HCC患者，其中268例患者单独行肝切除术，129例患者行新辅助HAIC。通过强化-治疗分析，采用log-rank检验比较两组的总生存期（OS）和无病生存期（DFS）。结果：单纯手术组1、3、5年OS分别为83.3%、62.9%、53.8%，新辅助HAIC组97.5%、80.7%、64.7%。单纯手术组1、3、5年DFS分别为48.8%、32.5%、26.2%，新辅助HAIC组为71.5%、61.7%、59.5%。新辅助HAIC组的OS明显延长(风险比[HR]， 0.506；95%置信区间[CI]， 0.347-0.734；P < 0.001)和DFS (HR, 0.466；95% ci, 0.357-0.609；P < 0.001)。新辅助HAIC组无HAIC相关死亡。结论：新辅助FOLFOX-HAIC可显著改善可切除单个≥7 cm肿瘤的HCC患者的OS和DFS，且毒性可接受。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.