Postoperative adjuvant arterial chemoembolization improves the survival of hepatitis B virus-related hepatocellular carcinoma: a retrospective control study.

BACKGROUND: The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization (TACE) remains controversial.

AIMS: We aim to investigate the survival effect of postoperative adjuvant TACE on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients (stage B, the Barcelona Clinic Liver Cancer staging).

METHODS: Sixty consecutive HBV-related HCC patients (stage B) from February 2006 to May 2009 undergoing surgical resection were included in this study. Of these 60 patients, 34 patients underwent surgery only (Group A) and 26 patients underwent surgery plus TACE (Group B). We followed-up until May 2013. Overall survival rates as well as prognostic factors were analyzed by the Kaplan-Meier method, the log-rank test or Cox's proportional hazard model. All patients' data were collected from the hospital medical records, which were described precisely after accurate clinical samples detection.

RESULTS: The 1-, 2-, and 3-year overall survival rates in surgery-only group were 58.8, 32.4 and 12.6%, and the rates in surgery plus TACE group were 73.1, 61.5, and 48.9%, respectively (P = 0.033). The median survival time of the two groups after surgery and surgery plus TACE was 15.0 months [95% confidence interval (CI) 10.714-19.286] and 35.0 months (95% CI 20.974-49.026). In multivariate analysis, hemoglobin, HBeAg, peripheral blood regulatory T cells and tumor size were independent prognostic elements for HBV-related HCC patients (stage B).

CONCLUSIONS: Postoperative adjuvant TACE improves the survival of patients with HBV-related HCC (stage B) after curative resection compared to surgery only.