Prophylactic Interventional Therapy After Hepatectomy for Primary Liver Cancer: A Clinical Comparative Study of FOLFOX-HAIC and TACE

Abstract

Background: The risk of recurrence remains high after resection of primary liver cancer, necessitating prophylactic interventional therapy to reduce recurrence rates and improve patients’ quality of life and prognostic outcomes. Objectives: The present study aimed to compare the clinical efficacy of hepatic arterial infusion chemotherapy (FOLFOX-HAIC) and transarterial chemoembolization (TACE) in prophylactic interventional therapy after resection of primary liver cancer. Methods: This retrospective cohort study enrolled 60 patients who underwent resection for primary liver cancer at Dongyang People’s Hospital from January 2022 to December 2024, with 30 patients assigned to the TACE group and 30 to the FOLFOX-HAIC group. After 2 years of follow-up, overall survival (OS), progression-free survival (PFS), symptomatic PFS, recurrence rates, and adverse events (AEs) were compared between groups. Survival analysis was performed using Kaplan-Meier curves, and differences between groups were compared using the log-rank test. Results: A 2-year follow-up of patients after primary liver cancer resection revealed that the FOLFOX-HAIC group exhibited significantly better performance in terms of mean OS, PFS, and symptomatic PFS compared to the TACE group, with statistical significance (P-values of 0.007, 0.016, and 0.019, respectively). Additionally, the recurrence rate was 66.67% (20/30) in the TACE group and 40.00% (12/30) in the FOLFOX-HAIC group, with a statistically significant difference (χ2 = 4.286; P = 0.038). In terms of adverse reactions, the TACE group primarily experienced embolization syndrome, with an incidence rate of 70.00% (21/30), whereas the FOLFOX-HAIC group mainly exhibited milder chemotherapy-related toxicity, with an incidence rate of 40.00% (12/30), and the difference was statistically significant (χ2 = 5.455; P = 0.020). Conclusions: The study indicates that compared with TACE, FOLFOX-HAIC provides longer OS, PFS, and symptomatic PFS, lower recurrence rates, and fewer and milder adverse reactions in patients after resection of primary liver cancer.