The Influence of Adjunctive Traditional Chinese Medicine Therapy on Survival in Primary Liver Cancer: A Real-world Study Based on EMRs

Abstract BackgroundPrimary liver cancer is a common clinical malignancy. Traditional Chinese medicine (TCM) is an alternative treatment for primary liver cancer. TCM effectively improves the survival rate and quality of life of patients, but high-level evidence is lacking.Patients and methodsThis study determined whether the combination of TCM and conventional cancer treatment affects the survival of liver cancer patients. Patients were selected from 5 tertiary hospitals in Henan Province. Two thousand and sixty-seven patients with primary liver cancer were included in the study for analysis. Patients who received adjunctive TCM treatment and underwent treatment for more than 1 month were classified as the TCM intervention cohort, i.e., the exposure group. Patients who did not receive adjunctive TCM treatment or who received adjunctive TCM treatment for less than 1 month were classified as the non-TCM intervention cohort, i.e., the non-exposed group. The main outcome indicators were the survival outcome and survival time of primary liver cancer patients. The propensity score inverse probability weighting method was used to balance the differences in the observed characteristics between the groups.ResultsThe primary cohort comprised 2,067 patients with primary liver cancer, including 462 patients who received adjunctive TCM treatment and 1,605 patients who did not receive adjunctive TCM treatment. Multiple logistic (binary) regression analysis results showed that adjunctive TCM treatment may reduce the mortality of primary liver cancer patients (regression coefficient = −0.82, P<0.001). The results of the Kaplan-Meier survival analysis indicated that the survival rate and median survival time of the exposure group before and after propensity score weighting were greater than those of the control group (P<0.0001). Multiple Cox regression analysis showed that adjunctive TCM treatment was an independent protective factor for survival in liver cancer patients (regression coefficient = −0.2477, hazard ratio (HR) = 0.7806, 95% confidence interval (CI) [0.6311–0.9655]), and cancer embolus was an independent risk factor (regression coefficient = 1.0546, HR = 0.3483, 95% CI [0.2831–0.4286]).ConclusionAdjuvant treatment with TCM has a protective effect on the prognosis of patients with primary liver cancer; it can reduce the mortality of primary liver cancer and prolong the survival time of patients. Cancer embolus is a risk factor that impacts the therapeutic effect of treatment in liver cancer patients.