The efficacy and safety analysis of D-TACE combined with donafenib and tislelizumab in recurrent hepatocellular carcinoma after surgery.

This retrospective study evaluated the efficacy and safety of drug-eluting bead transarterial chemoembolization (D-TACE) combined with Donafenib and Tislelizumab versus D-TACE with Sorafenib in 105 patients with recurrent hepatocellular carcinoma (HCC) after surgical resection (January 2019-June 2023). Patients were divided into D-TACE + Donafenib + Tislelizumab (N = 51) and D-TACE + Sorafenib (N = 54) groups. The D-TACE + Donafenib + Tislelizumab group demonstrated significantly higher objective response rate (62.7% vs. 40.7%, P < 0.05) and disease control rate (84.3% vs. 64.8%, P < 0.05), along with prolonged median progression-free survival (8.7 vs. 5.7 months, P < 0.001) and overall survival (19.2 vs. 12.3 months, P < 0.001). While hypothyroidism incidence was higher in the D-TACE + Donafenib + Tislelizumab group (21.6% vs. 7.4%, P = 0.051), the D-TACE + Sorafenib group exhibited increased fatigue (35.2% vs. 11.8%, P = 0.006) and anorexia (35.2% vs. 13.7%, P = 0.013). These findings suggest that D-TACE combined with Donafenib and Tislelizumab offers superior tumor control and survival benefits with a manageable safety profile, representing a promising therapeutic strategy for postoperative recurrent HCC.