Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2820-2830
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2820
Impact of hepatectomy and postoperative adjuvant transarterial chemoembolization on serum tumor markers and prognosis in intermediate-stage hepatocellular carcinoma
Yi-Di Hu, Hui Zhang, Wei Tan, Zhuo-Kai Li
Yi-Di Hu, Hui Zhang, Department of Surgery, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou 325000, Zhejiang Province, China
Wei Tan, Zhuo-Kai Li, Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang Province, China
Author contributions: Hu YD conceptualized the study and played a pivotal role in the initial development of the research framework; Hu YD and Zhang H were instrumental in the statistical analysis and interpretation of the data, bringing critical insights into the study’s findings; Tan W contributed significantly by providing the necessary software support, and was responsible for the visualization and formatting of the images used in the study, enhancing the overall presentation and clarity of the research; Hu YD and Li ZK were a collaborative effort in the writing of the manuscript, with both authors contributing equally to the composition and refinement of the text; Li ZK also conducted a thorough review of all the research data, ensuring accuracy and integrity in the study’s results.
Institutional review board statement: The study was approved by the Medical Ethics Committee of Lishui Central Hospital. The ethical number is Research Ethics Approval (2023) No. (665).
Informed consent statement: The data used in this study were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of Lishui Municipal Central Hospital. All patient data obtained, recorded, and managed only used for this study, and all patient information are strictly confidential, without any harm to the patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data covered within the article can be obtained from the corresponding author.
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: Zhuo-Kai Li, MMed, Chief Doctor, Doctor, Surgeon, Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, No. 289 Kuocang Road, Lishui 323000, Zhejiang Province, China. lizhuokai@hotmail.com
Received: November 3, 2023
Peer-review started: November 3, 2023
First decision: November 16, 2023
Revised: November 22, 2023
Accepted: December 8, 2023
Article in press: December 8, 2023
Published online: December 27, 2023
Abstract
BACKGROUND

Primary hepatocellular carcinoma (HCC) is a common malignant tumour, and its early symptoms are often not obvious, resulting in many patients experiencing middle- to late-stage disease at the time of diagnosis. The optimal time for surgery is often missed for these patients, and those who do undergo surgery have unsatisfactory long-term outcomes and a high recurrence rate within five years. Therefore, postoperative follow-up treatments, such as transhepatic arterial chemoembolization (TACE), have become critical to improving survival and reducing recurrence rates.

AIM

To validate the prophylactic role of TACE after hepatic resection and to assess its impact on patient prognosis.

METHODS

This study investigated the efficacy of TACE in patients with intermediate-stage HCC after hepatectomy. When the post-treatment results of the observation group and the control group were compared, it was found that the inclusion of TACE significantly improved the clinical efficacy, reduced the levels of tumour markers and did not aggravate the damage to liver function. Thus, this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC that helps to improve their quality of life and survival time.

RESULTS

When the baseline data were analysed, no statistical differences were found between the two groups in terms of gender, age, hepatitis B virus, cirrhosis, Child-Pugh grading, number of tumours, maximum tumour diameter and degree of tumour differentiation. The assessment of clinical efficacy showed that the post-treatment overall remission rate of the observation group was significantly higher than that of the control group. In terms of changes in tumour markers, the alpha-fetoprotein and carcinoembryonic antigen levels in the patients in the observation group decreased more significantly after treatment compared with those in the control group. When post-treatment changes in liver function indicators were analysed, no statistical differences were found in the total bilirubin, alanine aminotransferase and aspartate aminotransferase levels between the two groups.

CONCLUSION

In patients with intermediate-stage HCC, post-hepatectomy TACE significantly improved clinical outcomes, reduced tumour-marker levels and may have improved the prognosis by removing residual lesions. Thus, this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC.

Keywords: Primary liver cancer, Transhepatic arterial chemoembolization, Treatment outcome, Prognosis, Tumour markers, Liver function indices

Core Tip: This study investigated the efficacy of transhepatic arterial chemoembolization (TACE) in patients with intermediate-stage hepatocellular carcinoma (HCC) after hepatectomy. When the post-treatment results of the observation group and the control group were compared, it was found that the inclusion of TACE significantly improved the clinical efficacy, reduced the levels of tumour markers and did not aggravate the damage to liver function. Thus, this may be an effective and comprehensive treatment strategy for patients with intermediate-stage HCC that helps to improve their quality of life and survival time.