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Background <p>To evaluate and contrast the efficacy and safety of trans-arterial chemoembolization (TACE) versus hepatic arterial infusion chemotherapy (HAIC) for intermediate-stage hepatocellular carcinoma (HCC) based on varying radiologic patterns.</p> Methods <p>A retrospective study identified 3,060 consecutive patients with intermediate-stage HCC who underwent initial TACE or HAIC between January 2009 and December 2022. HCC radiological features were categorized into pseudo-capsulated, pseudocapsule breakthrough, confluent multinodular, and infiltrative types. The propensity score matching (PSM) method was employed to minimize selection bias. The progression-free survival (PFS) was compared using the Kaplan–Meier method with the log-rank test. Independent prognostic factors were assessed using a forward stepwise Cox regression model in multivariable analyses.</p> Results <p>After propensity score matching, each group in the infiltrative HCC cohort included 237 patients, while the non-infiltrative HCC cohort comprised 262 patients per group. Notably, radiologic patterns were shown with statistical significance in three groups with different tumor burden (<i>P</i> &lt; 0.001). Pseudo-capsulated type was dominant (55.6%) in &lt; 6 cohorts, and infiltrative type was dominant (49.5%) in &gt; 12 cohorts. A higher PFS was observed in the HAIC group compared to the TACE group in the infiltrative HCC cohort (<i>P</i> &lt; 0.001), but comparable PFS was found between the two groups in the non-infiltrative HCC cohort (<i>P</i> = 0.532). In the multivariate analysis, both tumor burden and radiologic morphology showed significant associations with PFS.</p> Conclusions <p>HAIC showed favorable outcomes in infiltrative HCC and might warrant further consideration in treatment planning.</p>

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Radiological characteristics for guiding intra-arterial therapy in intermediate-stage hepatocellular carcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月6日

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  • Chao An,
  • Guanglei Zheng,
  • Jiaoqing Zhou,
  • Ran Wei,
  • Peihong Wu,
  • Mengxuan Zuo

摘要

Background

To evaluate and contrast the efficacy and safety of trans-arterial chemoembolization (TACE) versus hepatic arterial infusion chemotherapy (HAIC) for intermediate-stage hepatocellular carcinoma (HCC) based on varying radiologic patterns.

Methods

A retrospective study identified 3,060 consecutive patients with intermediate-stage HCC who underwent initial TACE or HAIC between January 2009 and December 2022. HCC radiological features were categorized into pseudo-capsulated, pseudocapsule breakthrough, confluent multinodular, and infiltrative types. The propensity score matching (PSM) method was employed to minimize selection bias. The progression-free survival (PFS) was compared using the Kaplan–Meier method with the log-rank test. Independent prognostic factors were assessed using a forward stepwise Cox regression model in multivariable analyses.

Results

After propensity score matching, each group in the infiltrative HCC cohort included 237 patients, while the non-infiltrative HCC cohort comprised 262 patients per group. Notably, radiologic patterns were shown with statistical significance in three groups with different tumor burden (P < 0.001). Pseudo-capsulated type was dominant (55.6%) in < 6 cohorts, and infiltrative type was dominant (49.5%) in > 12 cohorts. A higher PFS was observed in the HAIC group compared to the TACE group in the infiltrative HCC cohort (P < 0.001), but comparable PFS was found between the two groups in the non-infiltrative HCC cohort (P = 0.532). In the multivariate analysis, both tumor burden and radiologic morphology showed significant associations with PFS.

Conclusions

HAIC showed favorable outcomes in infiltrative HCC and might warrant further consideration in treatment planning.