Hu YD, Zhang H, Tan W, Li ZK. Impact of hepatectomy and postoperative adjuvant transarterial chemoembolization on serum tumor markers and prognosis in intermediate-stage hepatocellular carcinoma. World J Gastrointest Surg 2023; 15(12): 2820-2830 [PMID: 38222017 DOI: 10.4240/wjgs.v15.i12.2820]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 Processing time: 54 Days and 2.4 Hours
ARTICLE HIGHLIGHTS
Research background
Primary liver cancer is a common malignant tumour with inconspicuous early symptoms, resulting in many patients being in the middle to late stage when diagnosed. Follow-up treatment after surgery is the key, in which transhepatic arterial chemoembolization (TACE), as an interventional therapy, has received more and more attention in recent years.
Research motivation
Although TACE is considered an effective treatment, controversy still exists regarding its prophylactic use after hepatic cancer resection. The aim of this study was to verify the prophylactic role of postoperative TACE and its impact on patient prognosis.
Research objectives
To assess the clinical efficacy of TACE after resection of hepatocellular carcinoma (HCC) and its effect on tumour markers and liver function indices. To further explore the prognostic factors affecting patients’ 5-year survival.
Research methods
This study compared the clinical data and treatment outcomes of two groups of patients with intermediate stage HCC. The observation group was treated with TACE after liver cancer resection, while the control group was not.
Research results
The overall effective rate of patients in the observation group was significantly higher than that of the control group. TACE treatment significantly reduced serum alpha-fetoprotein and carcinoembryonic antigen levels without exacerbating the impairment of liver function in patients. Cirrhosis, number of tumours, maximum tumour diameter and treatment regimen were identified as independent prognostic factors affecting patients’ 3-year survival.
Research conclusions
TACE after hepatectomy for HCC significantly improves clinical outcomes, reduces tumour marker levels and may improve prognosis by removing residual lesions. This provides an effective comprehensive treatment strategy for patients with intermediate-stage HCC.
Research perspectives
Future studies should expand the sample size and conduct prospective randomised controlled studies to further validate the findings of this study. In addition, exploring other possible integrated treatment strategies is also a direction for future research.