Baseline demographic data before propensity score matching
A total of 428 HCC patients were included in this study (Figure 1). The demographic and clinical features of the 428 patients (77.8% male, median age of 63 years) are shown in Table 1. Regarding the etiology of HCC, 47.9% of the patients had HBV infection, 32.4% had HCV infection, and 42.3% had excessive alcohol use. Approximately 54.7% of patients had liver cirrhosis, and of those patients, 86.9% had CP class A disease. Many (67.5%) of the patients had tumors ≥5 cm in size, and 65.0% of the patients had multiple tumors.
Overall survival of patients in the total and different treatment groups
Of the 428 patients, 257 (60.0%) died, and the median follow-up duration was 29 (range, 1-98) months (Table 1). The mortality rate was 24.8% per person-year. The cumulative OS rates at 1, 3, and 5 years were 80.8%, 50.6% and 32.8%, respectively (Figure 2A). Among the 428 patients, 140 (32.7%) patients received SR, 231 (53.9%) received TACE+RFA, and 57 (13.3%) received TACE (Table 1). The OS was significantly better in the SR group than in the TACE+RFA group (HR: 1.78; 95% CI: 1.15-2.75, p=0.009, Figure 2B). The OS was significantly better in the SR group than in the TACE group (HR: 3.17; 95% CI: 2.31-4.36, p<0.0001, Figure 2B). Moreover, the OS was significantly better in the TACE+RFA group than in the TACE group (HR: 1.82; 95% CI: 1.21-2.74, p=0.004, Figure 2B). The cumulative OS rates at 1, 3 and 5 years in the SR, TACE+RFA, and TACE groups were 89.2%, 69.4% and 61.2%, 86.0%, 57.9% and 38.2%, and 69.5%, 37.0% and 15.2%, respectively (Figure 2B).
Baseline demographic data after propensity score matching
The SR group showed significant differences compared with the TACE+RFA and TACE groups with respect to baseline features before PSM. The SR group had significantly lower rate of HCV infection cirrhosis, tumor number, and mortality, lower serum total bilirubin and INR level, and higher rate of CP class A and tumor size compared to the TACE+RFA and TACE groups (p<0.05) (Table 1). The PSM was performed with sex, age, cirrhosis, CP class, tumor size, and tumor number, and there were no significant differences for the important features (Table 2 and 3).
Overall survival of patients in the different treatment groups after propensity score matching
In the SR group versus TACE+RFA group after PSM (Table 2), 140 patients underwent SR, and 16 patients received TACE+RFA. Patients undergoing SR had significantly higher survival rates than patients receiving TACE+RFA (HR: 2.33; 95% CI: 1.21-4.49, p=0.011, Figures 3A). The cumulative OS rates at 1, 3 and 5 years in the SR and TACE+RFA groups were 89.2%, 69.4% and 61.2% and 81.3%, 50.0% and 26.8%, respectively (Figures 3A).
In the SR group versus TACE group after PSM (Table 2), 140 patients underwent SR, and 87 patients received TACE. Patients undergoing SR had significantly higher survival rates than patients receiving TACE treatments (HR: 3.10; 95% CI: 2.15-4.46, p<0.0001, Figures 3B). The cumulative OS rates at 1, 3 and 5 years in the SR and TACE groups were 89.2%, 69.4% and 61.2% and 70.1%, 36.3% and 15.7%, respectively (Figures 3B).
In the TACE+RFA group versus TACE group after PSM (Table 3), 56 patients received TACE+RFA, and 231 patients received TACE. Patients undergoing TACE+RFA had significantly higher survival rates than patients receiving TACE treatments (HR: 1.77; 95% CI: 1.22-2.56, p=0.002, Figures 3C). The cumulative OS rates at 1, 3 and 5 years in the TACE+RFA and TACE groups were 85.7%, 57.1% and 37.7% and 73.5%, 37.0% and 15.2%, respectively (Figures 3C).