Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2025; 17(2): 101177
Published online Feb 15, 2025. doi: 10.4251/wjgo.v17.i2.101177
Impact of Linggui Zhugan decoction on microwave ablation outcomes and recurrence in liver cancer
Rui Huang, Jing Cui
Rui Huang, Department of Acupuncture and Moxibustion, Baoji Central Hospital, Baoji 721000, Shaanxi Province, China
Jing Cui, Department of Liver Disease, Xi’an Daxing Hospital, Xi’an 710016, Shaanxi Province, China
Author contributions: Huang R and Cui J contributed to the study conception and design; Huang R performed data collection and analysis, and wrote the first draft of the manuscript; Cui J reviewed and revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: This study has been approved by the Baoji Central Hospital Ethics Committee (No. BZYL2024-59).
Informed consent statement: The study was exempt from informed consent requirement by the Ethics Committee of Baoji Central Hospital as it only involved retrospective data analysis. All patient data were anonymized, and the study was conducted in accordance with ethical standards to ensure patient privacy and confidentiality.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: Jing Cui, MMed, Attending Physician, Department of Liver Disease, Xi’an Daxing Hospital, No. 353 Laodong North Road, Lianhu District, Xi’an 710016, Shaanxi Province, China. cuijing20201@163.com
Received: September 25, 2024
Revised: November 5, 2024
Accepted: December 2, 2024
Published online: February 15, 2025
Processing time: 115 Days and 0.6 Hours
Abstract
BACKGROUND

Liver cancer is one of the most common malignant tumors of the digestive system, and early detection and effective treatment are crucial for improving the prognosis. Microwave ablation (MWA) has shown promising results as a local therapeutic method for liver cancer; however, further improvement of its efficacy remains a key focus of current research.

AIM

To evaluate the clinical efficacy of Linggui Zhugan decoction combined with MWA for the treatment of primary liver cancer.

METHODS

Data were collected from 164 patients with primary liver cancer who underwent MWA at our hospital between March 2019 and April 2021. Among them, 79 patients (control group) received routine treatments and 85 patients (research group) received Linggui Zhugan decoction in addition to routine treatment. The clinical efficacy, incidence of adverse reactions, and levels of serum alpha-fetoprotein (AFP), des-γ-carboxy prothrombin (DCP), AFP-L3, total bilirubin (TBil), alanine aminotransferase (ALT), CD4 cell count, CD8 cell count, and CD4/CD8 ratio were compared between the two groups, before and after treatment. The three-year recurrence rates between the two groups were compared, and independent prognostic factors for recurrence were identified.

RESULTS

The study results revealed that the objective response rate (ORR) in the research group was significantly higher than that in the control group (P = 0.005). After treatment, the CD4 cell count and CD4/CD8 ratio significantly increased, whereas the CD8 cell count and TBil, ALT, AFP, DCP, and AFP-L3 Levels were significantly lower in the research group than in the control group (P < 0.001). The Cox regression analysis revealed that the treatment regimen (P = 0.003), presence of cirrhosis (P = 0.019), tumor diameter (P = 0.037), Child-Pugh score (P = 0.003), pretreatment AFP level (P = 0.006), and AFP-L3 Level (P = 0.002) were independent prognostic factors for disease-free survival.

CONCLUSION

The combination of Linggui Zhugan decoction with MWA significantly improved the clinical efficacy and long-term prognosis of patients with primary liver cancer.

Keywords: Primary liver cancer; Microwave ablation; Linggui Zhugan decoction; Clinical efficacy; Disease-free survival; Cox regression analysis

Core Tip: This study revealed that the combination of Linggui Zhugan decoction with microwave ablation significantly improved clinical outcomes and prolonged disease-free survival (DFS) in patients with primary liver cancer. The independent prognostic factors identified for DFS included treatment modality, presence of cirrhosis, tumor diameter, Child-Pugh score, and pretreatment levels of alpha-fetoprotein (AFP) and AFP-L3. These findings provide valuable insights for the optimization of treatment strategies for patients with liver cancer that may improve their outcomes.