Background
Methods
Participants and criteria
TACE
Follow-up
Variables and outcomes
PSM
Statistical analysis
Results
Demographic and clinicopathological characteristics
Variable | Before Propensity Matching | After Propensity Matching | ||||
---|---|---|---|---|---|---|
Without TACE (n = 184) | Postoperative TACE (n = 46) | P | Without TACE (n = 46) | Postoperative TACE (n = 46) | P | |
Sex | 0.172 | > 0.99 | ||||
Men | 134 | 38 | 38 | 38 | ||
Women | 50 | 8 | 8 | 8 | ||
Mean age (y) | 52.3 ± 12.1 | 52 ± 10.7 | 0.326 | 53.4 ± 11.6 | 52 ± 10.7 | 0.834 |
HBsAg | > 0.99 | 0.810 | ||||
Positive | 136 | 34 | 35 | 34 | ||
Negative | 48 | 12 | 11 | 12 | ||
HBcAb | 0.666 | 0.231 | ||||
Positive | 153 | 9 | 42 | 9 | ||
Negative | 31 | 37 | 4 | 37 | ||
HCV antibody | > 0.99 | > 0.99 | ||||
Positive | 4 | 1 | 1 | 1 | ||
Negative | 180 | 45 | 45 | 45 | ||
Median AFP, ng/mL | 24.7 (1–80,000) | 96 (1.8–46,897) | 0.006 | 21.3 (1–30,728) | 96 (1.8–46,897) | 0.002 |
Median CEA, μg/mL | 2.5 (0–274) | 2.1 (0.5–70.5) | 0.364 | 2.7 (0.1–112.4) | 2.1 (0.5–70.5) | 0.423 |
Median CA19–9, U/ml | 28.1 (0–4370) | 19.4 (0.2–300.1) | 0.029 | 22 (0.5–4062.5) | 19.4 (0.2–300.1) | 0.023 |
Median bilirubin, μmol/L | 11.8 (1.7–314.8) | 12.9 (5.7–156.5) | < 0.001 | 13.7 (2.4–169.3) | 12.9 (5.7–156.5) | 0.664 |
Median albumin, g/L | 41 (26–55) | 42 (35–66) | 0.397 | 41 (30–48) | 42 (35–66) | 0.556 |
Median ALT, U/L | 28 (5–484) | 31 (5–104) | 0.094 | 26 (11–484) | 31 (5–104) | 0.109 |
Median ALP, IU/L | 89.5 (22–1413) | 88.5 (46–184) | 0.477 | 92 (25–331) | 88.5 (46–184) | 0.599 |
Median GGT, U/L | 59 (3.6–1632) | 80 (18–490) | 0.923 | 75.5 (10–658) | 80 (18–490) | 0.273 |
Median platelets, 103/μL | 13.7 (2.2–47.6) | 16 (3.9–46.1) | 0.319 | 15.3 (5.3–24.7) | 16 (3.9–46.1) | 0.171 |
Median prothrombin time, s | 11.8 (9–17.6) | 12 (10.2–13.8) | 0.941 | 12 (10.2–14.6) | 12 (10.2–13.8) | 0.903 |
Median INR | 1 (0.5–1.5) | 1 (0.8–1.2) | 0.227 | 1 (0.5–1.2) | 1 (0.8–1.2) | 0.065 |
Median tumour size, cm | 5 (1–24) | 7.3 (1.5–17) | 0.626 | 6 (1.5–22) | 7.3 (1.5–17) | 0.384 |
Median tumour nodularities | 1 (1–10) | 1 (1–5) | 0.140 | 1 (1–6) | 1 (1–5) | 0.648 |
Median blood loss, ml | 200 (30–3500) | 200 (10–2500) | 0.182 | 200 (50–1800) | 200 (10–2500) | 0.480 |
Mean occlusion, min | 6.8 ± 8.6 | 10 ± 1.6 | 0.044 | 5.4 ± 1.1 | 10 ± 1.6 | 0.090 |
Macrovascular invasion | 0.041 | > 0.99 | ||||
Positive | 11 | 7 | 7 | 7 | ||
Negative | 173 | 39 | 39 | 39 | ||
Microvascular invasion | 0.689 | 0.607 | ||||
Positive | 39 | 11 | 8 | 11 | ||
Negative | 145 | 35 | 38 | 35 | ||
Lymphoid metastasis | 0.840 | > 0.99 | ||||
Positive | 22 | 6 | 6 | 6 | ||
Negative | 162 | 40 | 40 | 40 | ||
Extrahepatic metastasis | 0.719 | 0.646 | ||||
Positive | 6 | 2 | 3 | 2 | ||
Negative | 178 | 44 | 43 | 44 | ||
Postrecurrent therapy | 0.451 | 0.583 | ||||
Resection | 2 | 1 | 1 | 1 | ||
TACE | 27 | 6 | 10 | 6 | ||
Regional therapy | 4 | 1 | 1 | 1 | ||
Chemothearpy | 66 | 14 | 11 | 14 | ||
Selective internal radiation therapy | 5 | 2 | 1 | 2 | ||
Stereotactic body radiation | 12 | 5 | 3 | 5 | ||
Best supportive care | 58 | 17 | 19 | 17 |
OS and DFS before PSM
The prognostic factors of CHC before PSM
Variable | Univariable | Multivariable | ||||
---|---|---|---|---|---|---|
HR | 95% CI | P | HR | 95% CI | P | |
Age (≥60/< 60, year) | 1.279 | 0.857–1.908 | 0.229 | – | – | – |
Sex (Men/Women) | 1.443 | 0.95–2.193 | 0.085 | – | – | – |
HBsAg (yes/no) | 1.044 | 0.719–1.517 | 0.821 | – | – | – |
HCV antibody (yes/no) | 2.293 | 0.722–7.283 | 0.159 | – | – | – |
AFP (≥20/< 20, ng/mL) | 2.819 | 0.68–11.682 | 0.153 | – | – | – |
CEA (≥5/<5, ng/mL) | 1.844 | 0.643–5.29 | 0.255 | – | – | – |
CA19–9 (≥37/<37, U/mL) | 2.069 | 0.639–6.702 | 0.225 | – | – | – |
Liver cirrhosis, yes (%) | 1.252 | 0.857–1.83 | 0.245 | – | – | – |
TB (≥17/< 17, μmol/L) | 0.950 | 0.626–1.443 | 0.810 | – | – | – |
ALB (≥40/<40, g/mL) | 0.759 | 0.530–1.086 | 0.132 | – | – | – |
ALT (≥35/<35, U/L) | 1.327 | 0.941–1.870 | 0.106 | – | – | – |
γ-GT (≥40/<40, U/L) | 2.662 | 1.703–4.163 | < 0.001 | 2.152 | 1.354–3.421 | 0.001 |
PLT (≥10/< 10 103/μL) | 1.005 | 0.665–1.518 | 0.982 | – | – | – |
Prothrombin time, median (range), s | 1.199 | 0.781–1.841 | 0.406 | – | – | – |
Tumour size, cm | 1.769 | 1.235–2.534 | 0.002 | 1.274 | 0.867–1.872 | 0.218 |
Tumour nodularities | 1.167 | 1.055–1.292 | 0.003 | 1.130 | 1.011–1.262 | 0.031 |
Occlusion, min (< 20/≥20) | 0.290 | 0.740–2.250 | 0.369 | – | – | – |
Macrovascular invasion (yes/no) | 1.927 | 1.442–2.576 | < 0.001 | 1.869 | 1.375–2.540 | < 0.001 |
Microvascular invasion (yes/no) | 1.365 | 0.921–2.204 | 0.122 | – | – | – |
Lymphoid metastasis (yes/no) | 2.801 | 1.745–4.495 | < 0.001 | 2.031 | 1.201–3.435 | 0.008 |
Extrahepatic metastasis (yes/no) | 11.435 | 5.262–24.849 | < 0.001 | 6.392 | 2.731–14.961 | < 0.001 |
Preventive TACE (yes/no) | 1.212 | 0.807–1.821 | 0.354 | – | – | – |
Variable | Univariable | Multivariable | ||||
---|---|---|---|---|---|---|
HR | 95% CI | P | HR | 95% CI | P | |
Age (≥60/< 60, year) | 1.240 | 0.765–2.010 | 0.382 | – | – | – |
Sex (Men/Women) | 1.751 | 1.042–2.941 | 0.034 | 1.919 | 1.097–3.357 | 0.022 |
HBsAg (yes/no) | 0.672 | 0.405–1.114 | 0.123 | – | – | – |
HCV antibody (yes/no) | 0.782 | 0.108–5.636 | 0.807 | – | – | – |
AFP (≥20/< 20, ng/mL) | 1.245 | 0.824–1.881 | 0.299 | – | – | – |
CEA (≥5/<5, ng/mL) | 1.169 | 0.672–2.035 | 0.581 | – | – | – |
CA19–9 (≥37/<37, U/mL) | 1.136 | 0.727–1.775 | 0.575 | – | – | – |
Liver cirrhosis, yes (%) | 1.291 | 0.815–2.044 | 0.277 | – | – | – |
TB (≥17/< 17, μmol/L) | 0.998 | 0.607–1.641 | 0.995 | – | – | – |
ALB (≥40/<40, g/mL) | 0.771 | 0.499–1.191 | 0.241 | – | – | – |
ALT (≥35/<35, U/L) | 1.741 | 1.154–2.267 | 0.008 | 1.676 | 1.050–2.677 | 0.031 |
γ-GT (≥40/<40, U/L) | 1.811 | 1.116–2.938 | 0.016 | 1.105 | 0.653–1.870 | 0.711 |
PLT (≥10/< 10 103/μL) | 0.856 | 0.529–1.382 | 0.524 | – | – | – |
Prothrombin time, median (range), s | 1.417 | 0.845–2.375 | 0.186 | – | – | – |
Tumour size, cm | 1.226 | 0.809–1.857 | 0.338 | – | – | – |
Tumour nodularities | 1.056 | 0.918–1.215 | 0.442 | – | – | – |
Occlusion, min (< 20/≥20) | 2.363 | 1.356–4.119 | 0.002 | 1.790 | 0.974–3.289 | 0.061 |
Macrovascular invasion (yes/no) | 1.878 | 1.300–2.713 | 0.001 | 2.026 | 1.342–3.058 | 0.001 |
Microvascular invasion (yes/no) | 1.084 | 0.654–1.797 | 0.754 | – | – | – |
Lymphoid metastasis (yes/no) | 2.300 | 1.287–4.112 | 0.005 | 2.835 | 1.517–5.297 | 0.001 |
Extrahepatic metastasis (yes/no) | 2.248 | 0.538–9.395 | 0.267 | – | – | – |
Preventive TACE (yes/no) | 2.799 | 1.815–4.317 | < 0.001 | 2.763 | 1.769–4.314 | < 0.001 |
PSM for TACE and non-TACE patients
OS and DFS after PSM
The prognostic factors of CHC after PSM
Variable | Univariable | Univariable | ||||
---|---|---|---|---|---|---|
HR | 95% CI | P | HR | 95% CI | P | |
Age (≥60/< 60, year) | 0.922 | 0.463–1.837 | 0.818 | – | – | – |
Sex (Men/Women) | 1.458 | 0.689–3.087 | 0.324 | – | – | – |
HBsAg (yes/no) | 1.711 | 0.887–3.300 | 0.109 | – | – | – |
HCV antibody (yes/no) | 6.405 | 1.491–27.524 | 0.013 | 9.142 | 2.028–41.225 | 0.004 |
AFP (≥20/< 20, ng/mL) | 1.288 | 0.761–2.181 | 0.346 | – | – | – |
CEA (≥5/<5, ng/mL) | 1.643 | 0.924–2.923 | 0.091 | – | – | – |
CA19–9 (≥37/<37, U/mL) | 1.591 | 0.932–2.715 | 0.089 | – | – | – |
Liver cirrhosis, yes (%) | 1.952 | 1.091–3.493 | 1.379 | 6.264 | 0.734–2.590 | 0.318 |
TB (≥17/< 17, μmol/L) | 0.739 | 0.383–1.427 | 0.368 | – | – | – |
ALB (≥40/<40, g/mL) | 0.814 | 0.476–1.391 | 0.451 | – | – | – |
ALT (≥35/<35, U/L) | 1.459 | 0.869–2.452 | 0.153 | – | – | – |
γ-GT (≥40/<40, U/L) | 1.811 | 0.933–3.515 | 0.079 | – | – | – |
PLT (≥10/< 10 103/μL) | 1.353 | 0.683–2.682 | 0.386 | – | – | – |
Prothrombin time, median (range), s | 1.014 | 0.547–1.880 | 0.964 | – | – | – |
Tumour size, cm | 1.466 | 0.814–2.639 | 0.203 | – | – | – |
Tumour nodularities | 1.017 | 0.785–1.318 | 0.898 | – | – | – |
Occlusion, min (< 20/≥20) | 1.560 | 0.735–3.310 | 0.247 | – | – | – |
Macrovascular invasion (yes/no) | 3.343 | 1.770–6.315 | < 0.001 | 3.035 | 1.543–5.972 | 0.001 |
Microvascular invasion (yes/no) | 1.359 | 0.725–2.546 | 0.338 | – | – | – |
Lymphoid metastasis (yes/no) | 1.487 | 0.667–3.315 | 0.332 | – | – | – |
Extrahepatic metastasis (yes/no) | 6.805 | 2.549–18.166 | < 0.001 | 6.264 | 2.277–17.235 | < 0.001 |
Preventive TACE (yes/no) | 0.911 | 0.545–1.520 | 0.720 | – | – | – |
Variable | Univariable | Multivariable | ||||
---|---|---|---|---|---|---|
HR | 95% CI | P | HR | 95% CI | P | |
Age (≥60/< 60, year) | 1.198 | 0.587–2.443 | 0.620 | – | – | – |
Sex (Men/Women) | 1.827 | 0.713–4.685 | 0.209 | – | – | – |
HBsAg (yes/no) | 1.478 | 0.706–3.096 | 0.300 | – | – | – |
HCV antibody (yes/no) | 0.048 | 0.526–4.934 | 0.665 | – | – | – |
AFP (≥20/< 20, ng/mL) | 1.075 | 0.585–1.976 | 0.815 | – | – | – |
CEA (≥5/<5, ng/mL) | 0.820 | 0.380–1.771 | 0.614 | – | – | – |
CA19–9 (≥37/<37, U/mL) | 1.019 | 0.520–1.997 | 0.957 | – | – | – |
Liver cirrhosis, yes (%) | 1.436 | 0.752–2.744 | 0.273 | – | – | – |
TB (≥17/< 17, μmol/L) | 0.941 | 0.449–1.973 | 0.873 | – | – | – |
ALB (≥40/<40, g/mL) | 0.580 | 0.315–1.068 | 0.080 | – | – | – |
ALT (≥35/<35, U/L) | 2.083 | 1.120–3.873 | 0.020 | 1.989 | 0.980–4.037 | 0.057 |
γ-GT (≥40/<40, U/L) | 1.265 | 0.616–2.597 | 0.521 | – | – | – |
PLT (≥10/< 10 103/μL) | 0.975 | 0.466–2.043 | 0.947 | – | – | – |
Prothrombin time, median (range), s | 1.841 | 0.942–3.598 | 0.074 | – | – | – |
Tumour size, cm | 1.077 | 0.560–2.071 | 0.823 | – | – | – |
Tumour nodularities | 0.992 | 0.731–1.346 | 0.957 | – | – | – |
Occlusion, min (< 20/≥20) | 3.308 | 1.388–6.647 | 0.005 | 1.565 | 0.639–3.833 | 0.327 |
Macrovascular invasion (yes/no) | 3.703 | 1.607–8.535 | 0.002 | 3.361 | 1.416–7.977 | 0.006 |
Microvascular invasion (yes/no) | 1.705 | 0.854–3.407 | 0.131 | – | – | – |
Lymphoid metastasis (yes/no) | 1.423 | 0.553–3.663 | 0.464 | – | – | – |
Extrahepatic metastasis (yes/no) | 2.246 | 0.520–9.712 | 0.279 | – | – | – |
Preventive TACE (yes/no) | 3.144 | 1.610–6.137 | 0.001 | 3.345 | 1.686–6.638 | 0.001 |