Effect of preoperative transcatheter arterial chemoembolization for treatment of resectable large hepatocellular carcinoma: A clinical randomized controlled trial / 第二军医大学学报

ABSTRACT

Objective: To evaluate the effect of preoperative transcatheter arterial chemoembolization (TACE) on liver function and survival of patients after resection of large hepatocellular carcinoma (HCC) by a randomized controlled approach. Methods: From July 2001 to December 2003, a total of 108 patients with resectable large HCC(≥ 5 cm) ,who met the inclusion criteria, were prospectively randomized into surgical resection group (OP group, n=56) or preoperative TACE group (TACE + OP group, n=52). Operative outcomes, resection rate, 1-,3-,and 5-year tumor-free survival rates and overall survival rate were compared between the two groups. Results: The preoperative baseline conditions were equivalent between the two groups. The γ-globulin level in TACE + OP group was significantly higher than that in the OP group(P = 0. 046) after chemoembolization. The prealbumin level was significantly lower than that of the OP group seven days after operation(P = 0. 031). Compared with TACE + OP group, OP group had a significantly higher resection rate (100% vs 89. 4% ,P=O. 017) ,a less average operative time (P=O. 042) ,and less metastases (2 vs 9,P=O. 018). There were no significant differences between the two groups in intraoperative blood loss, warm ischemic time, 1-,3-,and 5-year tumor-free survival rates,or overall survival rate. Conclusion: The preoperative TACE can not improve post-operative tumor-free and overall survival rates, and it may result in tumor metastasis or hepatic function damages.