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已发表论文
基于免疫疗法的策略与经导管动脉化疗栓塞术在伴有微血管侵犯的肝细胞癌中的比较以及治疗持续时间的影响：一项回顾性多中心队列研究
Authors Chen X , Xing J, Zhang B, Peng W, Huang Z, Zhu T , Liu L, Liu X , Wan X, Mao Y , Chang X, Zhou K, Pan J, Hu D, Tan H, Zhang Y , Guan M, Du S
Received 29 July 2025
Accepted for publication 7 October 2025
Published 21 October 2025 Volume 2025:12 Pages 2379—2391
DOI https://doi.org/10.2147/JHC.S556979
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Imam Waked
Xiaokun Chen,1,2,* Jiali Xing,1,2,* Baoluhe Zhang,1,2,* Wei Peng,3– 5 Ziyue Huang,1,2 Taifeng Zhu,1,2 Liguo Liu,6 Xiao Liu,1 Xueshuai Wan,1 Yilei Mao,1 Xiaoyan Chang,7 Kang Zhou,8 Jie Pan,8 Dandan Hu,3– 5 Haidong Tan,6 Yaojun Zhang,3– 5 Mei Guan,9 Shunda Du1
1Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 4Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 5State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, People’s Republic of China; 6Second Division of Hepatopancreatobiliary Surgery, China–Japan Friendship Hospital, Beijing, People’s Republic of China; 7Department of Pathology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 8Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 9Department of Oncology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shunda Du, Email dushd@pumch.cn
Background: Hepatocellular carcinoma (HCC) with microvascular invasion (MVI) is associated with high recurrence risk after curative resection. While adjuvant immune checkpoint inhibitors (ICIs) have shown potential in improving outcomes, there is no consensus on their optimal duration, and the comparative effectiveness versus transcatheter arterial chemoembolization (TACE) remains unclear.
Methods: We conducted a retrospective multicenter cohort study of 399 patients with microvascular invasion-positive hepatocellular carcinoma who underwent curative resection between 2017 and 2024. Patients receiving adjuvant ICIs or TACE were compared. Propensity score matching (PSM) was used to adjust baseline differences. The primary endpoint was recurrence-free survival (RFS); overall survival (OS) was assessed as a secondary endpoint. Subgroup analysis evaluated the impact of ICI treatment duration.
Results: Among 399 patients, 132 received TACE alone, and 129 received ICI-based therapy. Median RFS was significantly longer in the ICI group than in the TACE group (35 months vs 16 months; HR = 0.50, 95% CI: 0.34– 0.72; p = 0.00015). After PSM, ICI remained associated with improved RFS (HR = 0.54, 95% CI: 0.36– 0.82; p = 0.0042), while the OS difference was not statistically significant. In the ICI subgroup, treatment duration ≥ 12 months was associated with superior RFS (HR = 0.46, 95% CI: 0.21– 0.99; p = 0.041).
Conclusion: Among patients with HCC and MVI following curative resection, adjuvant ICIs therapy provides a significant recurrence-free survival advantage over TACE. Treatment durations shorter than 12 months may be insufficient, supporting the benefit of prolonged therapy.
Keywords: hepatocellular carcinoma, microvascular invasion, immune checkpoint inhibitor, immunotherapy, treatment duration
1Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 4Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 5State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangdong, People’s Republic of China; 6Second Division of Hepatopancreatobiliary Surgery, China–Japan Friendship Hospital, Beijing, People’s Republic of China; 7Department of Pathology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 8Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 9Department of Oncology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shunda Du, Email dushd@pumch.cn
Background: Hepatocellular carcinoma (HCC) with microvascular invasion (MVI) is associated with high recurrence risk after curative resection. While adjuvant immune checkpoint inhibitors (ICIs) have shown potential in improving outcomes, there is no consensus on their optimal duration, and the comparative effectiveness versus transcatheter arterial chemoembolization (TACE) remains unclear.
Methods: We conducted a retrospective multicenter cohort study of 399 patients with microvascular invasion-positive hepatocellular carcinoma who underwent curative resection between 2017 and 2024. Patients receiving adjuvant ICIs or TACE were compared. Propensity score matching (PSM) was used to adjust baseline differences. The primary endpoint was recurrence-free survival (RFS); overall survival (OS) was assessed as a secondary endpoint. Subgroup analysis evaluated the impact of ICI treatment duration.
Results: Among 399 patients, 132 received TACE alone, and 129 received ICI-based therapy. Median RFS was significantly longer in the ICI group than in the TACE group (35 months vs 16 months; HR = 0.50, 95% CI: 0.34– 0.72; p = 0.00015). After PSM, ICI remained associated with improved RFS (HR = 0.54, 95% CI: 0.36– 0.82; p = 0.0042), while the OS difference was not statistically significant. In the ICI subgroup, treatment duration ≥ 12 months was associated with superior RFS (HR = 0.46, 95% CI: 0.21– 0.99; p = 0.041).
Conclusion: Among patients with HCC and MVI following curative resection, adjuvant ICIs therapy provides a significant recurrence-free survival advantage over TACE. Treatment durations shorter than 12 months may be insufficient, supporting the benefit of prolonged therapy.
Keywords: hepatocellular carcinoma, microvascular invasion, immune checkpoint inhibitor, immunotherapy, treatment duration