Transarterial chemoembolization combined with apatinib versus transarterial chemoembolization alone for hepatocellular carcinoma with macroscopic vascular invasion: A propensity score matching analysis.

<bold>Context: </bold>Macroscopic vascular invasion in hepatocellular carcinoma (HCC) remains challenging to treat.<bold>Aims: </bold>The aim of this study was to compare the efficacy of transarterial chemoembolization (TACE)-apatinib therapy with TACE treatment alone in HCC patients with macrovascular invasion, using propensity score matching (PSM).<bold>Settings and Design: </bold>Matched paired comparison between the TACE-apatinib and TACE alone group using 1:2 PSM was utilized.<bold>Subjects and Methods: </bold>Between 2013 and 2019, 378 patients receiving TACE-apatinib or TACE alone were included based on specific selection criteria.<bold>Statistical Analysis Used: </bold>Multivariate Cox regression models were used to determine the independent prognostic factors for overall survival (OS).<bold>Results: </bold>Of the patients included, 40 (12.5%) received TACE-apatinib treatment and 280 (87.5%) received TACE alone. Tumor sizes of patients in the TACE-apatinib group were more frequently classified as small (<5 cm) compared to those in the TACE alone group (P = 0.021; mean: 8.6 cm vs. 10.2 cm). After 1:2 PSM, 40 pairs of HCC patients with well-matched covariates were selected from the two treatment groups. Patients in the TACE-apatinib group had higher OS rates than patients in the TACE alone group (P = 0.018). The median OS times were 18.2 and 8.5 months in the TACE-apatinib and TACE alone groups, respectively. The OS hazard ratio for the choice of TACE-apatinib treatment compared to TACE treatment alone was 0.50 (95% confidence interval: 0.28-0.90; P = 0.021).<bold>Conclusions: </bold>TACE combined with apatinib may result in superior OS compared to TACE therapy alone for HCC patients with macrovascular invasion. [ABSTRACT FROM AUTHOR]