Comparison of Postoperative Adjuvant CTACE vs DEB-TACE Combined with Tislelizumab and Lenvatinib in BCLC Stage B/C Hepatocellular Carcinoma: A Propensity Score-Matched Analysis of Survival Outcomes.

PURPOSE: This single-center, retrospective study aimed to compare the efficacy and safety of two adjuvant triple-therapy regimens-conventional transarterial chemoembolization (CTACE) versus drug-eluting bead TACE (DEB-TACE), each combined with tislelizumab and lenvatinib-in patients with BCLC stage B/C hepatocellular carcinoma (HCC) following curative resection.

METHODS

Using propensity score matching to minimize selection bias, we analyzed data from 211 eligible patients treated between March 2021 and June 2024. Key endpoints included overall survival (OS), progression-free survival (PFS), and adverse events (AEs).

RESULTS

After matching, the DEB-TACE-based regimen (DEB-TACE-T-L) was associated with significantly longer OS and PFS compared to the CTACE-based regimen (CTACE-T-L). In an exploratory subgroup analysis of 49 patients with microvascular invasion (MVI), those receiving DEB-TACE-T-L showed a promising trend toward improved survival outcomes; however, this finding should be interpreted as hypothesis-generating due to the limited sample size and lack of a statistically significant interaction between treatment type and MVI status. The safety profile was comparable between the two groups.

CONCLUSION

Our preliminary results suggest that adjuvant DEB-TACE-T-L may offer a survival benefit over CTACE-T-L in resected BCLC B/C HCC, with acceptable toxicity. The potential enhanced effect in MVI-positive patients observed here warrants further validation in larger, prospective studies.