Transarterial Chemoembolization Outcomes for Advanced Hepatocellular Carcinoma vs Sorafenib and Best Supportive Care in a Sub-Saharan African Cohort - Original Article - Retrospective Cohort Study

Sep 28, 2026

Uploaded by Putri

Sub-Saharan Africa and Southeast Asia account for most hepatocellular carcinoma cases, while low- and middle-income health systems face economic constraints that limit treatment options. This retrospective cohort study aimed to identify factors linked to poor outcomes in Barcelona Clinic Liver Cancer stage C and D patients receiving transarterial chemoembolization (TACE) and to compare outcomes with tyrosine kinase inhibitors or best supportive care. Univariate and multivariate regression and matched survival analyses were used to define predictive risks and inform TACE implementation in resource-limited settings.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Background

Aim

Methods

Results

Conclusion

Key Words

| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 December 14; 31(46): 112249 DOI: 10.3748/wjg.v31.i46.112249 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Retrospective Cohort Study Transarterial chemoembolization outcomes for advanced hepatocellular carcinoma vs sorafenib and best supportive care in a sub-Saharan African cohort Sanju Sobnach, Karla Christina Sousa Silva, Ebtesam Abdel-Rashid Abdel-Shafy, Muhammad Emmamally, Catherine Wendy Spearman, Marc Bernon, Mark W Sonderup, Keith Venter, Inae Kim, Urda Kotze, Rajshree Segobin, Dale K Creamer, Stefano Cacciatore, Luiz Fernando Zerbini, Eduard Jonas Specialty type: Gastroenterology and hepatology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade A, Grade A, Grade B, Grade B, Grade B Novelty: Grade A, Grade A, Grade B, Grade B, Grade B Creativity or Innovation: Grade A, Grade B, Grade B, Grade B, Grade B Scientific Significance: Grade A, Grade A, Grade B, Grade B, Grade B P-Reviewer: Balbaa M, PhD, Professor, Egypt; Giangregorio F, Assistant Professor, Chief Physician, Director, Italy; Ke Y, MD, PhD, Associate Professor, China Received: July 23, 2025 Revised: September 9, 2025 Accepted: October 31, 2025 Published online: December 14, 2025 Sanju Sobnach, Muhammad Emmamally, Marc Bernon, Keith Venter, Inae Kim, Urda Kotze, Eduard Jonas, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, Western Cape, South Africa Karla Christina Sousa Silva, Luiz Fernando Zerbini, Cancer Genomics Group, International Centre for Genetic Engineering and Biotechnology, Cape Town 7925, Western Cape, South Africa Ebtesam Abdel-Rashid Abdel-Shafy, Stefano Cacciatore, Bioinformatics Unit, International Centre for Genetic Engineering and Biotechnology, Cape Town 7925, Western Cape, South Africa Catherine Wendy Spearman, Mark W Sonderup, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, Western Cape, South Africa Rajshree Segobin, Dale K Creamer, Division of Radiology, University of Cape Town, Cape Town 7925, Western Cape, South Africa Co-first authors: Sanju Sobnach and Karla Christina Sousa Silva. Co-corresponding authors: Luiz Fernando Zerbini and Eduard Jonas. Corresponding author: Luiz Fernando Zerbini, Director, Cancer Genomics Group, International Centre for Genetic Engineering and Biotechnology, Anzio Road, Observatory, Cape Town 7925, Western Cape, [South Africa.](South Africa. luiz.zerbini@icgeb.org)[ luiz.zerbini@icgeb.org](South Africa. luiz.zerbini@icgeb.org) Abstract BACKGROUND Sub-Saharan Africa (SSA) and Southeast Asia account for 80% of hepatocellular carcinoma (HCC) cases globally. Public healthcare systems in low-and middleincome countries often face significant economic constraints, resulting in limited treatment options. The objectives of this study were to identify factors associated with poor outcomes in patients with Barcelona Clinic Liver Cancer (BCLC) stage C and D undergoing transarterial chemoembolization (TACE) and to compare WJG [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 14, 2025 Volume 31 Issue 46 Sobnach S et al. TACE outcome predictors in SSA Processing time: 140 Days and 20.2 Hours their outcomes to patients treated tyrosine kinase inhibitors (TKIs) or best supportive care (BSC) only. AIM To assess clinical outcomes and identify predictive factors that may facilitate the broader implementation of TACE in patients with advanced HCC within resource-constrained settings such as SSA. METHODS A single-center, retrospective cohort study was conducted to investigate the risk factors associated with the outcome of TACE in patient

FAQs

Which clinical factors were associated with poor TACE response in advanced HCC patients?

Elevated gamma-glutamyl transferase, elevated aspartate aminotransferase, and portal vein infiltration were identified as high-risk features linked to poor TACE response.

How did overall survival differ between patients treated with TACE versus TKIs or best supportive care?

Patients with BCLC stage C who lacked high-risk features had significantly longer overall survival with TACE compared with those receiving best supportive care or TKIs.

What was the study design and how were treatment groups compared?

A single-center retrospective cohort study used univariate and multivariate regression, frequency matching for confounders across TACE, TKIs, and best supportive care groups, and survival analysis to compare matched outcomes.

Sep 28, 2026

Uploaded by Putri