Postoperative adjuvant transcatheter arterial chemoembolization for hepatocellular carcinoma: A prospective study / 第二军医大学学报

ABSTRACT

Objective To evaluate the clinical value of postoperative adjuvant transcatheter arterial chemoembolization (TACE) on the prognosis of hepatocellular carcinoma (HCC) patients after radical hepatectomy using a prospective cohort study. Methods A total of 220 HCC patients underwent radical hepatectomy from Jan. 2008 to Dec. 2008 and 104 were recruited in the present study. Fifty-six patients (TACE group) received adjuvant TACE one month after hepatectomy, and 48 (control group) did not receive any adjuvant therapies. Follow-up was done regularly. The disease-free survival (DFS) time and total survival (TS) were statistically analyzed. Results The median DFS time in TACE group was significantly shorter than that in the control group (11 [2-38] months vs 13 [2-59] months, P = 0. 005). The 1-year, 2-year and 3-year recurrence rates were 50%, 85. 7%, and 89. 3% in TACE group and 46. 8%, 58. 3%, and 62. 5% in the control group(P = 0. 005), respectively. Multivariate COX regression analysis indicated that TACE, AFP, intact tumor peplos, liver cirrhosis, vascular invasion and tumor Edmondson-Steiner grade were the risk factors for recurrence (P<0. 05). The median TS time periods in TACE group and control group were 29 (4-41) months and 24 (5-59) months (P = 0. 789), respectively. The 1-year, 2-year and 3-year survival rates were 85. 6%, 59. 5%, and 36. 5% in TACE group and 75%, 50%, and 41. 7% in the control group (P = 0.789), respectively. Multivariate COX regression analysis indicated that AFP, intact tumor peplos and tumor Edmondson-Steiner grade were correlated with the total survival of patients (P<0. 05). Conclusion Adjuvant TACE can not improve DFS and TS of HCC patients after radical hepatectomy, and it may even contribute to a poor prognosis. Therefore more attention should be paid in choosing treatment strategy.