Prognostic Capabilities of Vessels Encapsulating Tumor Clusters in Patients With Unresectable HCC

Vessels encapsulating tumor clusters (VETC) may serve as an efficacy predictor in patients with unresectable hepatocellular carcinoma (HCC) who are undergoing hepatic arterial infusion chemotherapy (HAIC), according to a new study led by Drs. Wenping Lin, Lianghe Lu, Rongliang Zheng, and Shasha Yuan.

The study was published in the Journal of Cancer Research and Clinical Oncology.

Dr. Lin and colleagues noted that VETC is a novel vascular pattern with both functional and structural differences from microvascular invasion in unresectable HCC.

Researchers evaluated the data of 145 participating patients undergoing HAIC as the initial treatment for unresectable HCC from January 2016 to December 2017. The patients were separated into either the VETC+ (n=31, 21.8%) cohort or the VETC− (n=114, 78.2%) cohort based on their VETC status.

The study monitored patients’ overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and disease control rate (DCR).

Patients in the VETC− group demonstrated superior ORR (RECIST: 47.4%; P=.031; mRECIST: 52.6%; P=.008) and DCR (RECIST: 76.3%; P=.007; mRECIST: 76.3%; P=.007) when compared with ORR (RECIST: 25.8%; P=.031; mRECIST: 41.0%; P=.008) and DCR (RECIST: 56.1%; P=.007; mRECIST: 56.1%; P=.007) levels in the VETC+ group.

In the VETC+ cohort, patients experienced a median OS of 10.2 months compared with the median OS of 21.6 months (P=.001) in the VETC− cohort. The median PFS in the VETC+ group was significantly shorter than the VETC− group (3.3 vs 7.2 months; P=.001).

Through multivariate analysis, researchers found that VETC status is an independent prognostic factor for OS (hazard ratio [HR], 2.40; 95% CI, 1.46-3.94; P=.001) and PFS (HR, 1.97; 95% CI, 1.20-3.22; P=.007).

The researchers concluded that VETC status can assist in identifying patients who may benefit from HAIC and serves as a possible efficacy predictor. “VETC status correlates remarkably well with the tumor response and long-term survival in patients undergoing HAIC,” they wrote.