Effect of Huaier Granules combined with transarterial chemoembolization on recurrence and survival in postoperative hepatocellular carcinoma patients with microvascular invasion.

OBJECTIVE: To evaluate whether Huaier Granules combined with transcatheter arterial chemoembolization (TACE) reduces recurrence and improves survival in patients with microvascular invasion (MVI)-positive primary hepatocellular carcinoma (HCC) after resection. METHODS: A single-center retrospective study enrolled 266 patients (2019-2021), who were divided into the Huaier Granules + TACE group (Observation Group) (n=137) and the TACE alone group (Control Group) (n=129). Key outcomes included recurrence-free survival (RFS), overall survival (OS), objective response rate (ORR), liver function, adverse events (AEs), and health-related quality of life (HRQoL) assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Hepatocellular Carcinoma 18-question module. Survival was analyzed using the Kaplan-Meier method; Cox regression and receiver operating characteristic (ROC) analysis were employed to explore prognostic factors and evaluate discrimination. RESULTS: Compared with TACE alone, the combination group had a higher ORR (55.47% vs 38.76%, P<0.005), lower 1-/2-/3-year recurrence rates (16.79%/44.53%/78.10% vs 26.36%/53.48%/89.15%, P<0.05), and longer RFS and OS (both P<0.05). The combination group exhibited more significant improvements in alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and albumin (ALB) (all P<0.05), with a comparable AE rate (P>0.05) and better 3-month HRQoL (all P<0.05). Multivariable analysis identified Tumor-Node-Metastasis (TNM) stage, post-treatment AST, and treatment modality as independent predictors of 3-year mortality, with modest area under the curve values (0.572-0.699). CONCLUSION: Huaier Granules combined with TACE was associated with reduced recurrence, prolonged survival, favorable safety, and better short-term HRQoL in this cohort. These findings require cautious interpretation and prospective validation due to the study's limitations.