Analysis of the efficacy and influence factors for treatment of primary hepatocellular carcinoma by Huachansu tablets combined with transarterial chemoembolization

doi:10.16139/j.1007-9610.2024.04.13

Abstract

Abstract:

Objective To evaluate the efficacy of Huachansu tablets combined with transarterial chemoembolization (TACE) for treatment of primary hepatocellular carcinoma (HCC) and prognostic influence factors. Methods One hundred and eight patients with HCC were recruited according to the inclusion and exclusion criteria. Patients were randomly divided into treatment group and control group. The treatment group was treated with Huachansu tablets combined with TACE, and the control group was treated with TACE alone, with overall survival time (OS) and progression-free survival time (PFS) as the evaluation indexes. The COX regression analysis was used to evaluate the survival and prognostic effects and their influence factors in both groups. Results A total of 108 HCC patients were enrolled. The OS was 13.5 months in treatment group and 9.2 months in control group; the PFS was 6.8 months in treatment group and 5.3 months in control group, and the differences were significant statistically (all P<0.05). Multivariate COX regression analysis showed that Child-Pugh grade and cirrhosis were the independent risk factors for PFS in HCC patients. Child-Pugh grade were the independent risk factors for OS in HCC patients. ALBI is a protective factor for OS in HCC patients. Conclusions The treatment of HCC by Huachansu tablets combined with TACE can delay the progression of HCC and prolong PFS and OS of the patients with HCC. Child-Pugh grade, cirrhosis status, and ALBI were important factors affecting the prognosis of the patients with HCC.

Key words: Hepatocellular carcinoma(HCC), Huachansu tablet, Transarterial chemoembolization(TACE), Influencing factor

CLC Number:

R735.7

CHENG Chienshan, ZHANG Tao, WU Junwei, GAO Huifeng, CHEN Jingxian, MENG Zhiqiang. Analysis of the efficacy and influence factors for treatment of primary hepatocellular carcinoma by Huachansu tablets combined with transarterial chemoembolization[J]. Journal of Surgery Concepts & Practice, 2024, 29(04): 351-357.

Figures/Tables 4

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References 30

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Independent variable	Assignment
Gender	Male=1，Female=2
Hepatitis B virus (HBV） infection	No=1，Yes=2
Barcelona clinic liver cancer （BCLC）staging	Stage A=1，Stage B=2
Child-Pugh staging	Stage A=1，Stage B=2
Liver cirrhosis	No=1，Yes=2
AFP grouping	<400(μg/L)=1，≥400(μg/L)=2
Group	Treatment group=1, Control group=2

Variate	ALL(n=108)	Treatment group(n=54)	Control group(n=54)	P value
OS	10.70(8.90,17.00)	13.50(9.30,21.60)	9.20(4.30,16.30)	0.010
PFS	6.00(5.30,7.00)	6.80(6.00,8.50)	5.25(3.20,6.50)	0.012
SII（systemic inflammation index）	335.59(250.42,443.81)	304.30(224.82,525.92)	360.01(250.42,537.92)	0.576
Age(years)	53.30±10.33	53.65±10.06	52.94 ±10.69	0.725
Tumor size before treatment (mm)	71.07±44.27	72.50±50.30	69.65 ±37.72	0.740
Tumor size after treatment(mm)	73.15±51.67	72.77±54.23	73.55 ±49.41	0.939
Change in tumor size(mm)	1.07±31.43	-0.77±35.72	2.98 ±26.48	0.545
FIB(fibrinogen)	3.14±1.14	3.20±1.20	3.08 ±1.09	0.589
NLR (neutrophil/lymphocyte ratio)	2.74±2.10	2.72±2.40	2.77 ±1.77	0.898
PLR (platelet/lymphocyte ratio)	126.47±91.87	128.57±100.77	124.37 ±82.93	0.813
LMR (lymphocyte/monocyte ratio)	4.16±2.12	4.21±2.17	4.10 ±2.08	0.787
APRI (aspartate aminotransferase/platelet ratio)	0.39±0.34	0.35±0.24	0.42 ±0.42	0.265
ALBI (albumin/bilirubin ratio)	-2.66±0.56	-2.71±0.59	-2.62 ±0.53	0.419
Gender				0.081
Male	60(55.56%)	35(64.81%)	25(46.30%)
Female	48(44.44%)	19(35.19%)	29(53.70%)
HBV infection				0.674
No	6( 5.56%)	2(3.70%)	4(7.41%)
Yes	102(94.44%)	52(96.30%)	50(92.59%)
Child-Pugh staging				1.000
Stage A	71(65.74%)	35(64.81%)	36(66.67%)
Stage B	37(34.26%)	19(35.19%)	18(33.33%)
Liver cirrhosis				0.759
No	12(11.11%)	7(12.96%)	5(9.26%)
Yes	96(88.89%)	47(87.04%)	49(90.74%)
BCLC staging				0.648
Stage A	25(23.15%)	11(20.37%)	14(25.93%)
Stage B	83(76.85%)	43(79.63%)	40(74.07%)
AFP grouping (μg/L)				0.826
<400	28(25.93%)	15(27.78%)	13(24.07%)
≥400	80(74.07%)	39(72.22%)	41(75.93%)

Variable	Univariate		Multivariate
Variable	HR(95% CI)	P value	HR(95% CI)	P value
Age(yeras)	0.984(0.963,1.005)	0.135	--	--
Gender	1.118(0.750,1.666)	0.583	--	--
HBV infection	1.708(0.746,3.912)	0.205	--	--
BCLC staging	1.044(0.657,1.659)	0.855	--	--
Tumor size before treatment (mm)	1.002(0.998,1.007)	0.271	--	--
Tumor size after treatment(mm)	1.003(0.999,1.007)	0.188	--	--
NLR (neutrophil/lymphocyte ratio)	1.280(0.868,1.886)	0.213	--	--
PLR (platelet/lymphocyte ratio)	0.916(0.619,1.355)	0.659	--	--
LMR (lymphocyte/monocyte ratio)	0.902(0.613,1.329)	0.602	--	--
SII (systemic inflammation index)	1.080(0.731,1.595)	0.698	--	--
APRI (aspartate aminotransferase/platelet ratio)	0.999(0.677,1.475)	0.997	--	--
ALBI (albumin/bilirubin ratio)	0.813(0.561,1.179)	0.275	--	--
FIB (fibrinogen)	1.005(0.839,1.203)	0.960	--	--
Child-Pugh staging	2.447(1.603,3.736)	<0.001	1.952(1.264,3.014)	0.003
Liver cirrhosis	4.547(2.093,9.879)	<0.001	4.691(1.824,12.065)	0.001
AFP grouping	1.840(1.134,2.987)	0.014	0.726(0.412,1.282)	0.270
Group	1.539(1.034,2.290)	0.034	1.303(0.871,1.950)	0.198

Variable	Univariate		Multivariate
Variable	HR(95% CI)	P value	HR(95% CI)	P value
Age(yeras)	0.979(0.957,1.001)	0.066	--	--
Gender	1.246(0.814,1.908)	0.312	--	--
HBV infection	2.174(0.876,5.392)	0.094	--	--
AFP grouping	1.452(0.894,2.359)	0.132	--	--
BCLC staging	1.163(0.704,1.921)	0.555	--	--
Tumor size before treatment (mm)	1.001(0.996,1.006)	0.642	--	--
Tumor size after treatment(mm)	0.863(0.775,0.961)	0.007	--	--
NLR (neutrophil/lymphocyte ratio)	1.259(0.826,1.921)	0.284	--	--
PLR (platelet/lymphocyte ratio)	1.013(0.662,1.551)	0.952	--	--
LMR (lymphocyte/monocyte ratio)	1.093(0.715,1.670)	0.683	--	--
SII (systemic inflammation index)	1.156(0.757,1.766)	0.502	--	--
APRI (aspartate aminotransferase/platelet ratio)	1.023(0.671,1.559)	0.916	--	--
FIB (fibrinogen)	0.963(0.800,1.159)	0.690	--	--
Child-Pugh staging	2.036(1.313,3.158)	0.001	1.637(1.029,2.604)	0.037
Liver cirrhosis	2.035(1.049,3.949)	0.036	1.571(0.786,3.138)	0.201
ALBI (albumin/bilirubin ratio)	0.568(0.388,0.832)	0.004	0.616(0.417,0.911)	0.015
Group	1.612(1.055,2.464)	0.027	1.531(1.001,2.342)	0.049

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