The effect of postoperative adjuvant transcatheter hepatic arterial chemoembolization on survival of patients after resection of huge hepatocellular carcinoma / 肿瘤

ABSTRACT

Objective: To investigate the efficacy of postoperative transcatheter arterial chemoembolization (TACE) on survival of patients after resection of huge hepatocellular carcinoma. Methods: This study retrospectively collected the clinical data of 256 huge hepatocellular carcinoma patients who had received radical resection. Among them 136 patients received postoperative adjuvant TACE 4-6 weeks post resection, and the other 120 patients received surgical resection only. Stratification analysis was performed on all the patients according to with or without high risk factor for residual tumor (satellite nodules, tumor thrombosis in the > 2nd stream of the portal vein, and un-integrated membrane). Survival rate was compared between the two groups. Results: For patients who had huge HCC without high risk factor for residual tumor, the 1-, 3-, and 5-year survival rates were 80.43%, 59.92%, and 47.18% for post-operative adjuvant TACE group, respectively; 74.05%, 53.40%, and 45.77% for surgical resection group, respectively. There was no statistical difference in the survival rate between the two groups (P = 0.7693). For those with high risk factor for residual tumor, 1-, 3-, and 5-year survival rates were 72.15%, 32.27%, and 22.35% for postoperative adjuvant TACE group, respectively; and 45.36%, 22.47%, and 19.67% for only surgical resection group, respectively. There was statistical difference between the two groups (P = 0.004 9). COX regression analysis indicated that postoperative adjuvant TACE (HR0.620, 95% CI 0.442 - 0.870) and high risk factor for residual tumor (HR2.235, 95% CI 1.491-3.351) were independent risk factors for postoperative long-term survival. Conclusion: Postoperative TACE is highly helpful in increasing the long-term survival rate of patients with huge hepatocellular carcinoma, and it is more effective in elongating the postoperative survival time of patients with high risk factor for residual tumor.