Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2024; 16(11): 3463-3470
Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3463
Clinical study of different interventional treatments for primary hepatocellular carcinoma based on propensity-score matching
Xiao-Bo Cheng, Li Yang, Ming-Qian Lu, Yi-Bo Peng, Lei Wang, Shuang-Ming Zhu, Zhi-Wei Hu, Zhong-Liang Wang, Qin Yang
Xiao-Bo Cheng, Li Yang, Yi-Bo Peng, Lei Wang, Shuang-Ming Zhu, Zhi-Wei Hu, Zhong-Liang Wang, Qin Yang, Department of Oncology, Dangyang People’s Hospital, Dangyang 444100, Hubei Province, China
Ming-Qian Lu, Department of Oncology, Yichang Central People’s Hospital (The First Clinical Medical School of China Three Gorges University), Yichang 443008, Hubei Province, China
Co-first authors: Xiao-Bo Cheng and Li Yang.
Author contributions: Cheng XB and Yang L contributed equally to this work. Cheng XB and Yang L designed the manuscript; Lu MQ supervised this study; Yang Q analyzed the data and supervised this study; Peng YB and Wang L prepared the figures; Zhu SM, Hu ZW, and Wang ZL organized the clinical data.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Dangyang People’s Hospital.
Informed consent statement: Informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qin Yang, MBBS, Chief Physician, Department of Oncology, Dangyang People’s Hospital, No. 71 Yuyang Road, Dangyang 444100, Hubei Province, China.15272106678@163.com
Received: August 8, 2024
Revised: September 9, 2024
Accepted: September 25, 2024
Published online: November 27, 2024
Processing time: 83 Days and 6.1 Hours
Abstract
BACKGROUND

Transcatheter arterial chemoembolization (TACE) is the main treatment for patients with primary hepatocellular carcinoma (PHC) who miss the opportunity to undergo surgery. Conventional TACE (c-TACE) uses iodized oil as an embolic agent, which is easily washed by blood and affects its efficacy. Drug-eluting bead TACE (DEB-TACE) can sustainably release chemotherapeutic drugs and has a long embolization time. However, the clinical characteristics of patients before the two types of interventional therapies may differ, possibly affecting the conclusion. Only a few studies have compared these two interventions using propensity-score matching (PSM).

AIM

To analyze the clinical effects of DEB-TACE and c-TACE on patients with PHC based on PSM.

METHODS

Patients with PHC admitted to Dangyang People’s Hospital (March 2020 to March 2024) were retrospectively enrolled and categorized into groups A (DEB-TACE, n = 125) and B (c-TACE, n = 106). Sex, age, Child-Pugh grade, tumor-node-metastasis stage, and Eastern Cooperative Oncology Group score were selected for 1:1 PSM. Eighty-six patients each were included post-matching. Clinical efficacy, liver function indices (aspartate aminotransferase, alanine aminotransferase, total bilirubin, and albumin), tumor serum markers, and adverse reactions were compared between the groups.

RESULTS

The objective response and disease control rates were significantly higher in group A (80.23% and 97.67%, respectively) than in group B (60.47% and 87.21%, respectively) (P < 0.05). Post-treatment levels of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were lower in group A than in group B (P < 0.05), whereas post-treatment levels of albumin in group A were comparable to those in group B (P > 0.05). Post-treatment levels of tumor serum markers were significantly lower in group A than in group B (P < 0.05). Patients in groups A and B had mild-to-moderate fever and vomiting symptoms, which improved with conservative treatment. The total incidence of adverse reactions was significantly higher in group B (22.09%) than in group A (6.97%) (P < 0.05).

CONCLUSION

DEB-TACE has obvious therapeutic effects on patients with PHC. It can improve liver function indices and tumor markers of patients without increasing the rate of liver toxicity or adverse reactions.

Keywords: Primary hepatocellular carcinoma; Iodized oil; Drug-carrying microspheres; Transhepatic arterial chemoembolization; Propensity-score matching; Curative effect

Core Tip: Primary hepatocellular carcinoma is a malignant digestive disease with a high mortality rate. In this study, we found that drug-eluting bead transcatheter arterial chemoembolization treatment has more obvious effects than conventional transcatheter arterial chemo-embolization treatment. It can improve the liver function indices and tumor marker levels of these patients and does not increase the rate of liver toxicity or adverse reactions.