A study of the effect of immunotherapy on 5-year survival in locally treated early and middle stage hepatocellular carcinoma——based on the Liver Cancer Clin-Bio Databank of Anhui Hepatobiliary Surgery Union(LCCBD_AHSU)
WANG Yong-shuai
ZHANG Feng
ZHANG Shen-yu
SONG Rui-peng
CAI Wei
ZHANG Shu-geng
WANG Jia-bei
YIN Da-long
LIU Lian-xin
WANG Ji-zhou
Abstract：Objective To investigate the effect of immunotherapy on the 5-year survival in locally treated early and middle-stage hepatocellular carcinoma undergoing local treatment.Methods Clinical data of 2609 patients with early and middle-stage hepatocellular carcinoma treated with local therapy admitted to 22 centers from the Liver Cancer Clin-Bio Databank of Anhui Hepatobiliary Surgery Union(LCCBD_AHSU)from October 2010 to February 2024 were retrospectively analyzed.Propensity score matching(PSM)was used according to 1∶1 nearest neighbor matching method,and there were 236 patients in each group of immunotherapy and non-immunotherapy after matching.Overall survival(OS)was compared between the two groups,and the risk factors of OS were analyzed by the Cox regression model.Results(1)Before PSM,OS was longer in the immunotherapy group compared with the non-immunotherapy group(P＜0.001);after matching the PSM,the OS of patients in the immunotherapy group was still longer(P＜0.001).(2)After matching the PSM,the results of the univariate analysis showed that cirrhosis(HR=0.45,95％CI0.31-0.65,P＜0.001),radical surgical resection(HR=0.23,95％CI 0.16-0.34,P＜0.001),immunotherapy after recurrence(HR=0.59,95％CI 0.40-0.89,P=0.011)were the protective factors for the OS of patients,while Child-Pugh class B(HR=2.43,95％CI 1.48-3.98,P＜0.001),the maximum tumor diameter ≥5 cm(HR=1.92,95％CI 1.32-2.82,P＜0.001)and alpha-fetoprotein(AFP)≥400 µg/L(HR=1.52,95％CI 1.06-2.17,P=0.023)were the risk factors for the OS of patients.The results of the multivariate analysis showed that antiviral therapy(HR=0.62,95％CI0.39-0.99,P=0.044),radical surgical resection(HR=0.33,95％CI 0.21-0.51,P＜0.001)and immunotherapy after recurrence(HR=0.64,95％CI 0.42-0.96,P=0.031),immunotherapy after recurrence(without perioperative immunotherapy)(HR=0.22,95％CI 0.08-0.62,P=0.004)were the independent protective factors affecting the OS of patients.Conclusion Compared with local therapy alone,immunotherapy may provide survival benefits and prolong the OS of patients with early and middle-stage hepatocellular carcinoma undergoing local treatment.
Keywords：immunotherapyhepatocellular carcinomaprognosisdatabank
Publication Date：2024-09-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1055-1061 )