Abstract
BackgroundAlthough the transcatheter arterial chemoembolization (TACE) was demonstrated to be an alternative treatment of hepatocellular carcinoma with favorable oncological effect, the benefit of postoperative adjuvant TACE was still controversial. The aim of this study was to evaluate the effect of postoperative TACE in hepatocellular carcinoma.ResultsThe 1, 3, and 5–year overall and disease–free survival rates were comparable between Surgery+TACE and Surgery groups. In subgroup analysis, tumor size (≥ 5 cm) was detrimental to disease–free survival (p = 0.028) and an inferior tendency of overall survival was presented. Besides, repeated TACE for patients contributed to a poor disease–free survival (p = 0.005). While, postoperative adjuvant TACE improved the overall survival in patients with high preoperative alpha–fetoprotein or positive pathologically (p = 0.039 and p = 0.045).Materials and MethodsThe data were collected from consecutive patients between January 2010 and September 2014. After propensity score matching, baseline characteristics, overall and disease–free survival were compared between two groups. Subsequently, univariate and subgroup analysis were carried on.ConclusionsOur study indicated that single postoperative adjuvant TACE was beneficial for selected patients of stage I with tumor less than 5 cm, or high preoperative alpha–fetoprotein in serum or positive of alpha–fetoprotein pathologically.
Highlights
Hepatocellular carcinoma (HCC) is the fifth common cancer and the third leading cause of cancer–related death worldwide. [1] Merely 20% patients diagnosed as HCC are applicable for operation, and transcatheter arterial chemoembolization (TACE) is the refenrenced treatment for patients with unresectable tumor. [2,3,4,5] Theoretically, TACE is inducing the hypoxia and necrosis of tumor by embolism of feeding artery, and suppressing tumor activity through chemotherapy. [6, 7]While, it is worrying that postoperative TACE, as an adjuvant therapy, brings down therapeutic effect due to the removal of tumor previously
The 1, 3, and 5–year overall and disease–free survival rates were comparable between Surgery+TACE and Surgery groups
Postoperative adjuvant TACE improved the overall survival in patients with high preoperative alpha– fetoprotein or positive pathologically (p = 0.039 and p = 0.045)
Summary
Hepatocellular carcinoma (HCC) is the fifth common cancer and the third leading cause of cancer–related death worldwide. [1] Merely 20% patients diagnosed as HCC are applicable for operation, and transcatheter arterial chemoembolization (TACE) is the refenrenced treatment for patients with unresectable tumor. [2,3,4,5] Theoretically, TACE is inducing the hypoxia and necrosis of tumor by embolism of feeding artery, and suppressing tumor activity through chemotherapy. [6, 7]While, it is worrying that postoperative TACE, as an adjuvant therapy, brings down therapeutic effect due to the removal of tumor previously. Only few of studies with respect to postoperative adjuvant TACE in the treatment of HCC in American Joint Committee On Cancer (AJCC) stage I, were published, [8,9,10,11]. The randomized controlled trial is the ideal method to elucidate the benefits and drawbacks of postoperative adjuvant TACE, it is difficult to recruit enough patients to analyze the survival rates. Under such a circumstance, retrospective study based on propensity www.impactjournals.com/oncotarget score matching minimized the selection bias to increase the level of evidence. The aim of this study was to analyze retrospectively whether the postoperative adjuvant TACE was beneficial or not for patients of HCC in AJCC Stage I. The aim of this study was to evaluate the effect of postoperative TACE in hepatocellular carcinoma
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