Adjuvant transcatheter arterial chemoembolization after curative liver resection for hepatocellular carcinoma

Abstract

Objective To study the effect of adjuvant transcatheter arterial chemoembolization (TACE) on intrahepatic recurrence after curative liver resection for primary hepatocellular carcinoma (PHC). Methods 130 PHC patients who underwent curative liver resection from June 2010 to February 2013 were selected and randomly allocated to the study group (n=67) and the control group (n=63). The study group underwent adjuvant TACE for 1~4 times, and the control group did not receive any adjuvant therapy. On follow-up for 36 months, the postoperative recurrence rates, tumour free survival time and tumor free survival rates of the two groups were compared. Results At 6 months after surgery, the serum AFP level [(379.8±91.7) μg/L vs. (414.5±84.3) μg/L] and the IGFBP-2 level [(2 855.3±727.5) μg/L vs. (3 259.6±894.1) μg/L] in the study group were significantly lower than the control group (P 0.05). The 3-year cumulative tumor free survival rate of the study group (81.0% vs. 73.2%) was significantly higher than the control group (P 0.05). The recurrent rates of patients who underwent TACE 1 time and those who did not receive TACE showed no significant difference (P>0.05). In patients who had TACE twice, the 1-year (4.3% vs. 28.6%), 2-year (15.2% vs. 41.3%) and 3-year (26.1% vs. 49.2) cumulative recurrence rates were significantly lower than patients who did not receive TACE (P 0.05). Conclusions Adjuvant TACE helped to reduce PHC recurrence after curative liver resection during the high-risk period for recurrence. A 1-time TACE did not significantly reduce postoperative recurrence rate, and ≥3 times TACE did not significantly improve tumor-free survival rates. Adjuvant TACE and the number of TACE should be reasonably carried out based on the indications and pathological characteristics. Key words: Hepatocellular carcinoma; Transcatheter arterial chemoembolization; Pathological characteristic; Prognosis