PDF(Pubmed)
Abstract：
Despite that surgical resection is widely regarded as the most effective approach to the treatment of liver cancer, its safety and efficacy upon centrally located hepatocellular carcinoma (HCC) remain unsatisfactory. In consequence, seeking an integrated treatment, like combined with adjuvant radiotherapy, to enhance the prognosis of patients is of critical importance. By recruiting patients undergoing surgical resection for centrally located HCC ranging from June 2015 to 2020, they were divided into liver resection combined with adjuvant radiotherapy (LR + RT) and mere liver resection (LR) groups. The calculation of propensity score and model of Cox proportional hazards regression were utilized. 193 patients were recruited in aggregation, containing 88 ones undergoing LR + RT, while 105 handled with LR. RT was verified to be an independent factor of prognosis for relapse (HR 0.60). In propensity-score analyses, significant association existed between adjuvant radiotherapy and better disease-free survival (DFS) (Matched, HR 0.60; Adjustment of propensity score, HR 0.60; Inverse probability weighting, HR 0.63). The difference of DFS was apparent within two groups (p value = 0.022), and RT significantly down-regulated early relapse (p value < 0.05) in subgroup analysis. The calculation of E-value revealed robustness of unmeasured confounding. The combination of liver surgical resection with RT is safe and effective towards patients with centrally located HCC, which would notably enhance the prognosis and decrease the early relapse of HCC.
摘要：
尽管手术切除被广泛认为是治疗肝癌的最有效方法，其对位于中央的肝细胞癌（HCC）的安全性和有效性仍不令人满意。因此，寻求综合治疗，比如联合辅助放疗，提高患者的预后至关重要。通过招募2015年6月至2020年接受中央位置HCC手术切除的患者，他们被分为肝切除联合辅助放疗（LR+RT）和单纯肝切除（LR）组。使用倾向评分的计算和Cox比例风险回归模型。193名患者被招募到聚集中，包含88个正在接受LR+RT的，而105用LR处理。RT被证实是复发的独立预后因素(HR0.60)。在倾向得分分析中，辅助放疗与更好的无病生存期(DFS)之间存在显著关联(匹配，HR0.60；倾向评分调整，HR0.60；逆概率加权，HR0.63）。两组间DFS差异明显(p值=0.022),在亚组分析中，RT显着下调了早期复发（p值<0.05）。E值的计算揭示了不可测量的混杂的鲁棒性。肝脏手术切除与RT的组合是安全和有效的对患者的中央定位肝癌，这将显著提高预后和减少肝癌的早期复发。
