Outcomes of Salvage Surgery for Initially Unresectable Hepatocellular Carcinoma Converted by Transcatheter Arterial Chemoembolization Combined with Lenvatinib plus Anti-PD-1 Antibodies: A Multicenter Retrospective Study.

Content Provider	Europe PMC
Author	Wu, Jia-Yi Zhang, Zhi-Bo Zhou, Jian-Yin Ke, Jing-Peng Bai, Yan-Nan Chen, Yu-Feng Wu, Jun-Yi Zhou, Song-Qiang Wang, Shuang-Jia Zeng, Zhen-Xin Li, Yi-Nan Qiu, Fu-Nan Li, Bin Yan, Mao-Lin
Copyright Year	2022
Abstract	Introduction The actual rate of conversion surgery and its prognostic advantages remain unclear. This study aimed to assess the outcomes of salvage surgery after conversion therapy with triple therapy (transcatheter arterial chemoembolization [TACE] combined with lenvatinib plus anti-PD-1 antibodies) in patients with initially unresectable hepatocellular carcinoma (uHCC). Methods Patients with initially uHCC who received at least one cycle of first-line triple therapy and salvage surgery at five major cancer centers in China were included. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) rates after salvage surgery. The secondary endpoints were perioperative complications, 90-day mortality, and pathological tumor response. Results Between June 2018 and December 2021, 70 patients diagnosed with uHCC who underwent triple therapy and salvage surgery were analyzed: 39 with Barcelona Clinic Liver Cancer (BCLC) stage C, 22 with BCLC stage B, and 9 with BCLC stage A disease. The median interval between the start of triple therapy and salvage surgery was 4.3 months (range, 1.7–14.2 months). Pathological complete response and major pathological response were observed in 29 (41.4%) and 59 (84.3%) patients, respectively. There were 2 cases of perioperative mortality (4.3%) and 5 cases of severe perioperative complications (7.1%). With a median follow-up of 12.9 months after surgery (range, 0.3–36.8 months), the median OS and RFS were not reached. The 1- and 2-year OS rates were 97.1% and 94.4%, respectively, and the corresponding RFS rates were 68.9% and 54.4%, respectively. Conclusion First-line combination of TACE, lenvatinib, and anti-PD-1 antibodies provides a better chance of conversion therapy in patients with initially uHCC. Furthermore, salvage surgery after conversion therapy is effective and safe and has the potential to provide excellent long-term survival benefits.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10521320&blobtype=pdf
Page Count	9
ISSN	22351795
Volume Number	12
DOI	10.1159/000528356
PubMed Central reference number	PMC10521320
Issue Number	3
PubMed reference number	37767067
Journal	Liver Cancer
e-ISSN	16645553
Language	English
Publisher	Karger Publishers
Publisher Date	2022-11-30
Publisher Place	Allschwilerstrasse 10, CH-4055 Basel, Switzerland
Access Restriction	Open
Rights License	This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel
Subject Keyword	Hepatocellular carcinoma Conversion therapy Salvage surgery Systemic treatment Transcatheter arterial chemoembolization
Content Type	Text
Resource Type	Article
Subject	Hepatology Oncology