Hepatic arterial infusion chemotherapy with cisplatin before radical local treatment of early hepatocellular carcinoma (JIS Score 0/1) improves survival

Menée sur 114 patients atteints d'un carcinome hépatocellulaire de stade précoce, cette étude évalue, du point de vue des taux cumulés de survie à 1, 3 et 5 ans, l'efficacité d'une chimiothérapie à base de cisplatine par perfusion artérielle hépatique avant un traitement local radical

Résumé en anglais

Background : It has not yet been determined whether hepatic arterial infusion (HAI) chemotherapy improves survival in patients with early hepatocellular carcinoma (HCC). We evaluated the effectiveness of HAI with high-concentration cisplatin (DDP-H) for the treatment of HCC by comparing outcomes between patients who received HAI with DDP-H before radical local treatment of early-stage HCC (Japan Integrated Staging (JIS) score 0/1) and patients who did not receive HAI chemotherapy.

Patients and methods : Survival was analyzed in 114 patients with early-stage HCC who underwent radical local treatment. The patients were divided into two groups: a HAI group (n=79) who received DDP-H infusion into the whole liver via the proper hepatic artery, and a non-HAI group (n=35) who did not receive HAI chemotherapy.

Results : The cumulative survival rates at 1, 3, and 5 years were 77.4%, 69.2%, and 55.3% in the non-HAI group and 97.4%, 87.0%, and 84.4% in the HAI group, respectively. Survival time prolonged significantly in the HAI group compared with the non-HAI group (Log-Rank test: P=0.023; Generalized Wilcoxon test: P=0.012) Multivariate analysis using the Cox proportional hazards model identified HAI with DDP-H as the most important factor affecting survival.

Conclusions : Whole-liver HAI with DDP-H before radical local treatment can improve the prognosis of patients with early-stage HCC.