Efficacy and safety of transarterial chemoembolization in recurrent hepatocellular carcinoma after curative surgical resection.

OBJECTIVES: To evaluate the efficacy and safety of transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after curative resection and to examine the factors associated with the prognosis in a single center.

METHODS: Between January 1995 and July 2006, 169 patients who had undergone curative resection were diagnosed with recurrent HCC. Of these, 114 patients underwent TACE as first-line therapy and were followed until July 2007.

RESULTS: At the time of resection, the mean tumor size was 4.8 + or - 2.9 cm, and 96 (84.2%) patients had a single tumor. Single nodular recurrence was observed in 53 (46.5%) patients. The mean size of the recurrent HCC was 2.1 + or - 1.2 cm. The disease-free survival after TACE was 46.0%, 16.7%, and 13.4% at 1, 2, and 3 years, respectively. The overall survival after TACE was 77.8%, 53.6%, and 31.6% at 1, 3, and 5 years, respectively. Cox regression analysis revealed that the Edmonson grade and time to recurrence (>6 months) independently affected the disease-free survival (both P < 0.05). The time to recurrence (>6 months) and tumor-node-metastasis stage were associated with overall survival (both P < 0.05). Only 1 lethal complication (biliary sepsis) occurred after TACE.

CONCLUSIONS: TACE seems to be a safe, effective treatment for recurrent HCC after curative resection.