Oncotarget

Clinical Research Papers:

Postoperative adjuvant radiotherapy is associated with improved survival in hepatocellular carcinoma with microvascular invasion

Liming Wang, Weihu Wang, Xuesong Yao, Weiqi Rong, Fan Wu, Bo Chen, Mei Liu, Shengtao Lin, Yunhe Liu and Jianxiong Wu _

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Oncotarget. 2017; 8:79971-79981. https://doi.org/10.18632/oncotarget.20402

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Abstract

Liming Wang1,*, Weihu Wang2,*, Xuesong Yao3, Weiqi Rong1, Fan Wu1, Bo Chen4, Mei Liu5, Shengtao Lin1, Yunhe Liu1 and Jianxiong Wu1

1Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

2Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China

3Department of Interventional Therapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

4Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

5Laboratory of Cell and Molecular Biology and State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

*These authors contributed equally to this work

Correspondence to:

Jianxiong Wu, email: dr.wujx@hotmail.com

Keywords: hepatocellular carcinoma, microvascular invasion, TACE, radiotherapy, relapse-free survival

Received: May 24, 2017     Accepted: August 04, 2017     Published: August 23, 2017

ABSTRACT

Purpose: Limited studies have compared the efficacy of postoperative adjuvant therapies in HCC patients with microvascular invasion (MVI). In this study we assess the efficacy of postoperative adjuvant conservative therapy (CT), trans-catheter arterial chemoembolization (TACE) and radiotherapy (RT) in HCC patients with MVI.

Results: Kaplan-Meier survival analysis revealed that patients in the RT group have significantly improved RFS (RT vs TACE: p = 0.011; RT vs CT: p < 0.001) and OS (RT vs. TACE: p = 0.034; RT vs CT: P < 0.001) compared to TACE and CT groups. Further, subgroup analysis based on the degree of MVI and surgical margin width showed that patients with narrow surgical margin have significantly longer RFS and OS after adjuvant RT than the TACE and CT, independent of degree of MVI. Multivariate analysis indicated that MVI classification is the independent prognostic factor associated with RFS and OS.

Materials and Methods: Between July 2008 and December 2015, 136 HCC patients with MVI were divided into three groups according to their adjuvant therapies. Survival outcomes namely relapse-free survival (RFS) and overall survival (OS) of the three groups were analyzed.

Conclusions: Adjuvant radiotherapy following hepatectomy could result in better survival outcomes for HCC patients with MVI than TACE or CT.


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