Abstract
BACKGROUND: This study aimed to assess the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with apatinib and camrelizumab in patients with recurrent hepatocellular carcinoma (HCC) following hepatectomy. METHODS: From July 2020 to December 2024, consecutive medical records of recurrent HCC patients treated with HAIC plus apatinib/camrelizumab were retrospectively reviewed. Key outcomes, including overall survival (OS), progression-free survival (PFS), therapeutic response, and treatment-related complications, were evaluated. RESULTS: The study was followed up until January 31, 2025, with a median follow-up duration of 11 months (range: 2-26 months). Among the 110 eligible recurrent HCC patients (91 males and 19 females), 62 deaths were recorded. The objective response rate (ORR) was 31.8%, and the disease control rate (DCR) was 87.3%. The median OS was 14 months (95% CI: 12.9-15.1 months), with multivariable analysis identifying vascular invasion as an independent prognostic factor for OS. The median PFS was 7 months (95% CI: 5.3-8.7 months), and the platelet-to-lymphocyte ratio was found to be an independent prognostic factor for PFS. All adverse events were manageable, and no treatment-related deaths occurred. CONCLUSION: HAIC combined with apatinib/camrelizumab is effective and safe in the treatment of recurrent HCC after hepatectomy, which may be a promising treatment for recurrent HCC.