Neoadjuvant therapy: Dawn of reducing the high post-surgery recurrence rate of hepatocellular carcinoma

Table 1 Summary of neoadjuvant locoregional therapy studies in hepatocellular carcinoma in the last five years

Disease	HCC stage/liver function	Treatment arms (n)	Neoadjuvant duration (weeks)	Preoperative stopping time (weeks)	Median follow-up (months)	Primary endpoints findings	Ref.
Resectable HCC	BCLC A/B exceeding the Milan criteria	Neoadjuvant TACE (82) vs direct surgery (82)	4-6	NA	36	1-year OS (97.2% vs 82.4%); 2-year OS (88.4% vs 60.4%); 3-year OS (71.6% vs 45.7%; P = 0.0011)	Fang et al[11]
Resectable HCC (> 5 cm)	NA	Neoadjuvant TACE (60) vs direct surgery (324)	NA	NA	24	DFS (P = 0.935); OS (P = 0.172)	Giannone et al[12]
Resectable HCC (> 5 cm)	Child-Pugh A/B	Neoadjuvant TACE (30) vs Direct surgery (30)	12	NA	24	2-year DFS (P = 0.7045)	Kobayashi et al[13]
Resectable HCC with PVTT	Child-Pugh A	Neoadjuvant HAIC (65) vs direct surgery (55)	9.6	NA	36	1-year OS (94.9% vs 84.6%); 3-year OS (78% vs 47.6%); 5-year OS (66.4% vs 37.2%; P < 0.001)	Hu et al[16]
Centrally located resectable HCC	Child-Pugh A	Neoadjuvant IMRT (41) vs direct surgery (121)	5-6	4-12	45	1-year OS (95% vs 82%); 3-year OS (70% vs 64%); 5-year OS (70% vs 54%; P = 0.0099); 1-year DFS (71% vs 52%); 3-year DFS (53% vs 38%); 5-year DFS (37% vs 34%; P = 0.034)	Wei et al[19]
A single and small (≤ 5 cm) HBV-related resectable HCC	BCLC A	Neoadjuvant IMRT (30) vs direct surgery (30)	NA	4	68	DFS (P = 0.448)	Salem et al[20]

TACE: Transcatheter arterial chemoembolization; HAIC: Hepatic artery infusion chemotherapy; IMRT: Intensity modulated radiotherapy; HCC: Hepatocellular carcinoma; PVTT: Portal vein tumor thrombus; BCLC: Barcelona Clinic Liver Cancer; OS: Overall survival; DFS: Disease-free survival; NA: Not available.