background. it remains uncertain whether patients with hepatocellular carcinoma (hcc) and portal vein tumor thrombus(pvtt) benefit from postoperative adjuvant trans-arterial chemoembolization(pa-tace).
methods. we retrospectively identified 540 patients to form the crude cohort and adopted propensity score matching analysis to assemble another cohort of 464 patients with similar baseline characteristics.univariate and multivariate cox analyses were performed in explor atorysubgroups to identify the independent effect of pa-tace on overall survival(os).
results. in the overall study population, univariate analysis showed pa-tace was associated with longer os [odds ratio (or) = 0.55,p = 0.001], and stratified analyses indicated an interaction between pvtt typesand patace on os (p = 0.057 for interaction). after matching, all of the characteristics were well balanced between the pa-tace and control groups (allp[ 0.05). multivariate cox analysis validated that the protective role of pa-tace was significant greater with the expansion of pvtt (type i, or 0.66;type ii, or 0.33; and type iii, or 0.33, respectively, p = 0.011 forinteraction). there also was evidence of treatment effect modification by pvtt type in the crude cohort (type i, or 0.60; type ii, or 0.32; and type iii, or0.32, respectively, p = 0.011 for interaction).
结果：在研究总人群中，单因素分析显示pa-tace治疗os更长[比值比(or) = 0.55,p = 0.001]。分层分析显示，pvtt类型与pa-tace治疗对os的影响相关（交互作用p=0.057）。配对后，pa-tace组和对照组的特征均做到了平衡（所有p＞0.05）。多因素分析证实pa-tace的作用随着pvtt的扩大而显着增加（i型，or 0.66；ii型，or 0.33；iii型，or 0.33，交互作用p = 0.011）。也有证据表明在原始队列中，pvtt类型影响治疗效果（i型，or 0.60；ii型，or 0.32；iii型，or 0.32，交互作用p = 0.011）。
conclusions. in patients with hcc and pvtt, pa-tace was associated with a lower risk of death, particularly, among those with pvtt involving right/left or main portal vein, after excluding patients who were unsuitable for this procedure at 1 month after surgery.