Is postoperative adjuvant transchatheter arterial chemoembolization necessary for small hepatocellular carcinoma patients: A randomized controlled trial / 第二军医大学学报

ABSTRACT

Objective To evaluate whether adjuvant transchatheter arterial chemoembolization (TACE) can reduce early recurrence of small hepatocellular carcinoma (SHCC) patients after surgical treatment using randomized controlled trial. Methods A total of 117 patients, who underwent radical hepatectomy from Sept. 2008 to Dec. 2009, were randomly divided into 2 groups. Fifty-nine patients (group A or TACE group) received adjuvant TACE one month after hepatectomy, and 58 (group B or control group) did not receive any adjuvant therapies. Follow-up was done regularly. The disease-free survival (DFS) time and recurrence rate within the following two years were analyzed. Results The median follow-up duration was 29 months in our study. Twenty-two recurrences happened within one year and all recurrences happened within two years. The mean DFS periods were (28. 93 ± 1. 40) months (range 5-29 months) and (26. 94 ± 1. 62) months (range 3-35 months) (P = 0. 443) in group A and B, respectively. The half-year, 1-year and 2-year recurrence rates of group A vs group B were 10. 2% vs 13.8%, 20. 3% vs 20. 7%, 25.7% vs 31. 2% (P = 0.443), respectively. Univariate analysis showed that infection of HBV DNA, blood transfusion, Edmondson-Steiner grade and tumor diameter (3 cm as cut-off point) were correlated with tumor recurrence (P<0. 05). Multivariate COX regression analysis indicated that HBV DNA, blood transfusion, and tumor diameter (3 cm as cut-off point) were independent factors of early recurrence. Conclusion Adjuvant TACE can not reduce early recurrence of SHCC with a low risk of recurrence, so it is not recommended as a routine therapy to prevent early tumor recurrence. Further study is needed to verify whether TACE can benefit the long-term recurrence and overall survival of patients.