Abstract
OBJECTIVE: To investigate the clinical efficacy of using a Jiedu formula as an adjunctive therapy in patients with hepatocellular carcinoma (HCC) after hepatectomy. METHODS: In total, 354 patients were included in this study. All patients were categorized into the traditional herbal medicine (THM) group (n =115) or the non-THM treatment (nTHM) group (n =239), with the Jiedu formula administered twice a day to the patients in the THM group. The primary outcome was recurrence-free survival (RFS). Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors associated with RFS. Then, the high risk of recurrence among patients was identified, and propensity score matching (PSM) and RFS analysis were performed to analyze the prognostic factors for the outcomes of patients at a high risk of recurrence in different groups. RESULTS: The one, two, three, and five-year RFS rates of the THM and nTHM groups were 76.4% vs66.1%, 65.5% vs48.8%, 57.9% vs39.9%, and 43.9% vs29.2%, respectively. The results of the Multivariate Cox analysis showed that giant tumors [hazard ratio (HR), 1.54, P = 0.04], poor degree of differentiation, microsatellite, or microvascular invasion (HR, 1.29, P= 0.09) increased the risk of recurrence. In the population with a high risk of recurrence, after PSM, the one, two, three, and five-year survival rates were 70.6% vs68.0%, 63.0% vs43.1%, 59.6% vs33.3%, and 41.9% vs26.4%, respectively. CONCLUSION: In this study, THM was found to be an effective agent for adjuvant therapy for HCC to prevent early recurrence of HCC after hepatic resection.