Not All Hepatocellular Carcinoma Patients with Microvascular Invasion After R0 Resection Could Be Benefited from Prophylactic Transarterial Chemoembolization: A Propensity Score Matching Study

Figures & data

Table 1 Clinicopathological Characteristics Before and After PSM

Characteristic		Before PSM			After PSM		P-value
		TACE (n=199)	Non-TACE (n=496)	TACE (n=199)	TACE (n=199)	Non-TACE (n=199)
Age (years)	<50	81 (40.7%)	200 (40.3%)	0.994	81 (40.7%)	84 (42.2%)	0.839
	≥50	118 (59.3%)	296 (59.7%)		118 (59.3%)	115 (57.8%)
Gender	Female	23 (11.6%)	68 (13.7%)	0.525	23 (11.6%)	26 (13.1%)	0.76
	Male	176 (88.4%)	428 (86.3%)		176 (88.4%)	173 (86.9%)
HBV	No	20 (10.1%)	77 (15.5%)	0.078	20 (10.1%)	22 (11.1%)	0.87
	Yes	179 (89.9%)	419 (84.5%)		179 (89.9%)	177 (88.9%)
Cirrhosis	No	56 (28.1%)	174 (35.1%)	0.095	56 (28.1%)	55 (27.6%)	1
	Yes	143 (71.9%)	322 (64.9%)		143 (71.9%)	144 (72.4%)
AFP (ng/mL)	≤400	111 (55.8%)	300 (60.5%)	0.291	111 (55.8%)	110 (55.3%)	1
	>400	88 (44.2%)	196 (39.5%)		88 (44.2%)	89 (44.7%)
Child-Pugh	A	187 (94.0%)	468 (94.4%)	0.987	187 (94.0%)	187 (94.0%)	1
	B	12 (6.0%)	28 (5.6%)		12 (6.0%)	12 (6.0%)
Transfusion	No	181 (91.0%)	451 (90.9%)	1	181 (91.0%)	178 (89.4%)	0.736
	Yes	18 (9.0%)	45 (9.1%)		18 (9.0%)	21 (10.6%)
Tumor number	Single	136 (68.3%)	386 (77.8%)	0.012	136 (68.3%)	138 (69.3%)	0.914
	Multiple	63 (31.7%)	110 (22.2%)		63 (31.7%)	61 (30.7%)
Tumor size	≤5	85 (42.7%)	231 (46.6%)	0.401	85 (42.7%)	83 (41.7%)	0.919
	>5	114 (57.3%)	265 (53.4%)		114 (57.3%)	116 (58.3%)
ES grading	I/II	184 (92.5%)	454 (91.5%)	0.802	184 (92.5%)	184 (92.5%)	1
	III/IV	15 (7.5%)	42(8.5%)		15 (7.5%)	15 (7.5%)
Capsule	Present	134 (67.3%)	343 (69.2%)	0.707	134 (67.3%)	137 (68.8%)	0.830
	Absent	65 (32.7%)	153 (30.8%)		65 (32.7%)	62 (31.2%)
Satellite	No	59 (29.6%)	178 (35.9%)	0.139	59 (29.6%)	59 (29.6%)	1
	Yes	140 (70.4%)	318 (64.1%)		140 (70.4%)	140 (70.4%)
BCLC stage	0	5 (2.5%)	25 (5.0%)	0.055	5 (2.5%)	6 (3.0%)	0.849
	A	141 (70.9%)	374 (75.4%)		141 (70.9%)	136 (68.3%)
	B	53 (26.6%)	97 (19.6%)		53 (26.6%)	57 (28.6%)
CNLC stage	Ia	58 (29.1%)	184 (37.1%)	0.109	58 (29.1%)	60 (30.2%)	0.884
	Ib	88 (44.2%)	215 (43.3%)		88 (44.2%)	82 (41.2%)
	IIa	30 (15.1%)	58 (11.7%)		30 (15.1%)	35 (17.6%)
	IIb	23 (11.6%)	39 (7.9%)		23 (11.6%)	22 (11.1%)
AJCC stage	Ia	5 (2.5%)	25 (5.0%)	0.077	5 (2.5%)	6 (3.0%)	0.917
	II	158 (79.4%)	408 (82.3%)		158 (79.4%)	155 (77.9%)
	IIIa	36 (18.1%)	63 (12.7%)		36 (18.1%)	38 (19.1%)

Abbreviations: TACE, transarterial chemoembolization; PSM, propensity score matching; HBV, hepatitis B virus; AFP, alpha-fetoprotein; ES, Edmondson–Steiner; BCLC, Barcelona Clinic Liver Cancer staging system; CNLC, China Liver cancer; AJCC, the American Joint of Cancer Committee system.

Figure 1 Flow chart of patients’ enrollment from the primary liver cancer big data.

Figure 2 Comparison of disease-free survival (DFS) and overall survival (OS) between the p-TACE and non-TACE groups before and after propensity score matching (PSM). DFS and OS before PSM (A and B). DFS and OS after PSM (C and D).

Table 2 Univariate and Multivariate Analysis of Disease-Free Survival and Overall Survival After PSM

Characteristics	DFS						OS
	Univariate		Multivariate		Univariate		Multivariate
	HR (95CI)	P-value	HR (95CI)	P-value	HR (95CI)	P-value	HR (95CI)	P-value
Age(≤50 years as ref)
>50 years	0.85 (0.67–1.09)	0.201			0.90 (0.68–1.19)	0.453
Gender(<Female as ref)
Male	0.90 (0.63–1.28)	0.571			0.80 (0.54–1.18)	0.263
HBV(No as ref)
Yes	1.12 (0.75–1.68)	0.582			1.03 (0.64–1.65)	0.914
Cirrhosis (No as ref)
Yes	1.09 (0.83–1.43)	0.518			0.91 (0.67–1.24)	0.557
AFP (≤400ng/mL as ref)
>400	1.28 (1.00–1.63)	0.047	1.37 (1.07–1.75)	0.012	1.51 (1.14–2.00)	0.004	1.59 (1.20–2.11)	0.001
Child-Pugh (A as ref)
B	1.36 (0.87–2.13)	0.177			1.40 (0.85–2.31)	0.184
Transfusion(No as ref)
Yes	1.33 (0.90–1.94)	0.419			1.23 (0.80–1.91)	0.345
Tumor number(Single as ref)
Multiple	1.62 (1.25–2.08)	<0.001	1.63 (1.26–2.10)	<0.001	1.40 (1.05–1.87)	0.024	1.40 (1.04–1.87)	0.025
Tumor size (≤5cm as ref)
>5cm	1.56 (1.22–2.01)	<0.001	1.57 (1.22–2.02)	<0.001	2.12 (1.57–2.88)	<0.001	2.28 (1.66–3.13)	<0.001
ES grading(I/II as ref)
III/IV	1.26 (0.82–1.94)	0.293			1.45 (0.90–2.33)	0.128
Capsule(Present as ref)
Absent	1.02(0.79–1.33)	0.854			1.40(1.05–1.87)	0.023	1.50(1.11–2.01)	0.007
Satellite(No as ref)
Yes	1.23(0.94–1.61)	0.134			1.07(0.79–1.45)	0.657
Adjuvant TACE(No as ref)
Yes	0.71(0.56–0.91)	0.007	0.69(0.54–0.88)	0.003	0.70(0.53–0.93)	0.013	0.66(0.50–0.88)	0.004

Abbreviations: PSM, propensity score matching; OS, overall survival; DFS, disease-free survival; HR, hazard ratio; CI, confidence interval; HBV, hepatitis B virus; AFP, alpha-fetoprotein; ES, Edmondson–Steiner; TACE, transarterial chemoembolization.

Figure 3 Subgroup analysis of disease-free survival (DFS) stratified by clinicopathological variables related to the prognosis in the matched cohort.

Figure 4 Subgroup analysis of overall survival (OS) stratified by clinicopathological variables related to the prognosis in the matched cohort.