经导管动脉化疗栓塞联合乐伐替尼加抗PD-1抗体转化为最初无法切除的肝癌的挽救手术结果:一项多中心回顾性研究。

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Cancer Pub Date : 2022-11-30 eCollection Date: 2023-08-01 DOI:10.1159/000528356
Jia-Yi Wu, Zhi-Bo Zhang, Jian-Yin Zhou, Jing-Peng Ke, Yan-Nan Bai, Yu-Feng Chen, Jun-Yi Wu, Song-Qiang Zhou, Shuang-Jia Wang, Zhen-Xin Zeng, Yi-Nan Li, Fu-Nan Qiu, Bin Li, Mao-Lin Yan
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引用次数: 4

摘要

引言:转化手术的实际发生率及其预后优势尚不清楚。本研究旨在评估最初不可切除的肝细胞癌(uHCC)患者接受三重治疗(经导管动脉化疗栓塞[TACE]联合乐伐替尼加抗PD-1抗体)转换治疗后的挽救手术的结果中国的五个主要癌症中心也被包括在内。主要终点是挽救手术后的总生存率(OS)和无复发生存率(RFS)。次要终点是围手术期并发症、90天死亡率和病理性肿瘤反应。结果:在2018年6月至2021年12月期间,对70名接受三联治疗和挽救手术的uHCC患者进行了分析:39名患者为巴塞罗那临床癌症(BCLC)C期,22名患者为BCLC B期,9名为BCLC A期。从开始三联治疗到挽救手术的中位间隔为4.3个月(范围为1.7-14.2个月)。病理完全反应29例(41.4%),主要病理反应59例(84.3%)。有2例围手术期死亡率(4.3%)和5例严重围手术期并发症(7.1%)。术后中位随访12.9个月(范围为0.3-36.8个月),未达到中位OS和RFS。1年和2年OS率分别为97.1%和94.4%,相应的RFS率分别为68.9%和54.4%。结论:TACE、乐伐替尼和抗PD-1抗体的一线联合治疗为最初的uHCC患者提供了更好的转化治疗机会。此外,转换治疗后的挽救性手术是有效和安全的,有可能提供极好的长期生存益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Outcomes of Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma Converted by Transcatheter Arterial Chemoembolization Combined with Lenvatinib plus Anti-PD-1 Antibodies: A Multicenter Retrospective Study.

Outcomes of Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma Converted by Transcatheter Arterial Chemoembolization Combined with Lenvatinib plus Anti-PD-1 Antibodies: A Multicenter Retrospective Study.

Outcomes of Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma Converted by Transcatheter Arterial Chemoembolization Combined with Lenvatinib plus Anti-PD-1 Antibodies: A Multicenter Retrospective Study.

Introduction: The actual rate of conversion surgery and its prognostic advantages remain unclear. This study aimed to assess the outcomes of salvage surgery after conversion therapy with triple therapy (transcatheter arterial chemoembolization [TACE] combined with lenvatinib plus anti-PD-1 antibodies) in patients with initially unresectable hepatocellular carcinoma (uHCC).

Methods: Patients with initially uHCC who received at least one cycle of first-line triple therapy and salvage surgery at five major cancer centers in China were included. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) rates after salvage surgery. The secondary endpoints were perioperative complications, 90-day mortality, and pathological tumor response.

Results: Between June 2018 and December 2021, 70 patients diagnosed with uHCC who underwent triple therapy and salvage surgery were analyzed: 39 with Barcelona Clinic Liver Cancer (BCLC) stage C, 22 with BCLC stage B, and 9 with BCLC stage A disease. The median interval between the start of triple therapy and salvage surgery was 4.3 months (range, 1.7-14.2 months). Pathological complete response and major pathological response were observed in 29 (41.4%) and 59 (84.3%) patients, respectively. There were 2 cases of perioperative mortality (4.3%) and 5 cases of severe perioperative complications (7.1%). With a median follow-up of 12.9 months after surgery (range, 0.3-36.8 months), the median OS and RFS were not reached. The 1- and 2-year OS rates were 97.1% and 94.4%, respectively, and the corresponding RFS rates were 68.9% and 54.4%, respectively.

Conclusion: First-line combination of TACE, lenvatinib, and anti-PD-1 antibodies provides a better chance of conversion therapy in patients with initially uHCC. Furthermore, salvage surgery after conversion therapy is effective and safe and has the potential to provide excellent long-term survival benefits.

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来源期刊
Liver Cancer
Liver Cancer Medicine-Oncology
CiteScore
20.80
自引率
7.20%
发文量
53
审稿时长
16 weeks
期刊介绍: Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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