Abstract
Purpose
Vessels encapsulating tumor clusters (VETC) is a novel vascular pattern structurally and functionally distinct from microvascular invasion (MVI) in hepatocellular carcinoma (HCC). This study aims to explore the prognostic value of VETC in patients receiving hepatic arterial infusion chemotherapy (HAIC) for unresectable HCC.
Methods
From January 2016 to December 2017, 145 patients receiving HAIC as the initial treatment for unresectable HCC were enrolled and stratified into two groups according to their VETC status. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and disease control rate (DCR) were evaluated.
Results
The patients were divided into two groups: VETC+ (n = 31, 21.8%) and VETC− (n = 114, 78.2%). The patients in the VETC+ group had worse ORR and DCR than those in the VETC− group (RECIST: ORR: 25.8% vs. 47.4%, P = 0.031; DCR: 56.1% vs. 76.3%, P = 0.007; mRECIST: ORR: 41.0% vs. 52.6%, P = 0.008; DCR: 56.1% vs. 76.3%, P = 0.007). Patients with VETC+ had significantly shorter OS and PFS than those with VETC− (median OS: 10.2 vs. 21.6 months, P < 0.001; median PFS: 3.3 vs. 7.2 months, P < 0.001). Multivariate analysis revealed VETC status as an independent prognostic factor for OS (HR: 2.40; 95% CI: 1.46–3.94; P = 0.001) and PFS (HR: 1.97; 95% CI: 1.20–3.22; P = 0.007).
Conclusion
VETC status correlates remarkably well with the tumor response and long-term survival in patients undergoing HAIC. It may be a promising efficacy predictor and help identify patients who will benefit from HAIC.
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Data availability
All data for the findings are available from the corresponding author.
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Funding
This study was supported by the National Natural Science Foundation of China (No. 82172579, No.82303879, No.82303875, No.82203111); Science and Technology Planning Project of Guangzhou (No. 2023A04J1777, No. 2023A04J1781); China Postdoctoral Science Foundation (2023M734035); Clinical Trials Project (5010 Project) of Sun Yat-sen University (No. 5010–2017009, No. 5010–2023001).
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Acquisition of data: WL, LL, RZ, SY. Statistical analysis: WL, LL. Interpretation of results: LL, SL. Manuscript drafting: WL. Critical revision of the manuscript: WW, YL. Study concept and design: RG, WW. All authors read and approved the final manuscript.
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This study obtained approval from the institutional ethical review boards of Sun Yat-sen University Cancer Center and adhered to the ethical guidelines in the 1975 Declaration of Helsinki.
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Lin, W., Lu, L., Zheng, R. et al. Vessels encapsulating tumor clusters: a novel efficacy predictor of hepatic arterial infusion chemotherapy in unresectable hepatocellular carcinoma. J Cancer Res Clin Oncol 149, 17231–17239 (2023). https://doi.org/10.1007/s00432-023-05444-0
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DOI: https://doi.org/10.1007/s00432-023-05444-0