COMPARATIVE STUDY
JOURNAL ARTICLE

Adjuvant transarterial chemoembolization after curative resection of hepatocellular carcinoma: a non-randomized comparative study

Tao Xi, Eric C H Lai, An-ru Min, Le-hua Shi, Dong Wu, Feng Xue, Kui Wang, Zhenlin Yan, Yong Xia, Feng Shen, Wan Yee Lau, Meng-chao Wu
Hepato-gastroenterology 2012, 59 (116): 1198-203
22580673

BACKGROUND/AIMS: Prevention of recurrence is the most important strategy to improve long-term survival after resection of hepatocellular carcinoma (HCC). This comparative study aimed to evaluate the outcome of adjuvant transarterial chemoembolization (TACE) after hepatectomy.

METHODOLOGY: From February 1996 and September 2001, 721 consecutive patients (adjuvant TACE treatment vs. control group; 145 vs. 576) with R0 resection for HCC were analyzed. The prospective data was analyzed retrospectively.

RESULTS: After a median follow-up of 75 months, 89 patients (61.4%) in the adjuvant TACE group and 355 patients (61.6%) in the control group had recurrent disease. There was no significant difference in the tumor recurrence rate between the 2 groups. There was significant difference in the tumor recurrence time between the 2 groups. The 1-, 3- and 5-year overall survival rates were 96.5%, 70.0% and 55.9%, respectively, for the adjuvant TACE group and 80.8%, 49.7% and 38.8%, respectively, for the control group. The 1-, 3- and 5-year disease-free survival rates were 79.9%, 54.9% and 48.4%, respectively, for the adjuvant TACE group and 60.2%, 39.8% and 31.5%, respectively, for the control group. The differences in the disease-free survival rates and the overall survival rates between the 2 groups were significant. In subgroup analysis, there was significant survival benefit in the adjuvant TACE group in the subgroup of patients with risk factors of recurrence - large tumor size, presence of satellite tumor nodules and narrow resection margin.

CONCLUSIONS: Adjuvant TACE improved surgical outcome in those patients with risk factors of HCC recurrence.

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