Adjuvant transcatheter arterial chemoembolization for curative hepatectomy of hepatocellular carcinoma / 中华肝胆外科杂志

ABSTRACT

Objective:To explore the effect of transcatheter chemoembolization (TACE) on recurrence and survival time of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) following curative resection.Methods:Of 724 HBV-related HCC patients who underwent curative resection in the Third Affiliated Hospital of Naval Military Medical University from October 2009 to August 2010 were retrospectively analyzed. Patients who underwent resection only and no recurrence within 3 months after surgery were classified into control group, while those received adjuvant TACE were classified into intervention group. The patients were further divided into 4 sub-groups according to tumor size, tumor number and tumor thrombus which were defined as risk factors for recurrence. Tumor diameter ≤5 cm with low or high risk factors (tumor number ≥2 or presence tumor thrombus) were in group 1 and group 2 respectively, tumor diameter >5 cm with low or high risk factors for recurrence were in group 3 and group 4 respectively.Results:A total of 354 patients were classified in the control group and 370 patients were classified in the TACE group. Adjuvant TACE showed an overall survival benefit in patients with tumor diameter >5 cm and presenting high risk factors, the 1-, 3-, and 5-year cumulative survival rates were 90.1%, 67.6%, and 46.5%, respectively, for the lip-TACE group 83.3%, 52.4%, and 33.3%, respectively, for the control group ( P<0.05). Patients with the tumor diameter ≤5 cm, there was no significant difference in cumulative survival between the TACE group and the control group regardless of the risk level ( P>0.05). There was no significant difference in recurrence curve between TACE group and control group in each stratum. Conclusions:Adjuvant TACE had no preventive effect on recurrence, but TACE can prolong the survival time of HCC patients with high risk factors for recurrence.