Postoperative adjuvant transarterial chemoembolization after curative resection reduces early recurrence of hepatocellular carcinoma

Abstract

Objective To investigate the efficacy of transarterial chemoemblozaition (TACE) in preventing, detecting and treating recurrence of hepatocellular carcinoma (HCC) in patients after liver resection. Methods 166 patients who underwent liver resection followed by adjuvant TACE and 190 patients with liver resection alone were retrospectively studied. Multivariate analyses and subgroup analyses were performed to investigate the risk factors of recurrence. The recurrence and survival rates were calculated. The role of postoperative adjuvant TACE in enhancing sensitivity of CT/MRI to detect recurrence was also analyzed. Results Multivariate analyses revealed tumor capsule invasion, vascular invasion and multiple no-dules were risk factors of early recurrence (all P<0.05). HBsAg positivity was closely related to late recurrence. The 6-, 12-, 18-, and 24-month recurrence rates between patients who underwent liver resection + TACE and liver resection alone were 23.2% vs 59.4%, 68.4% vs 72.5%, 83.1% vs 89.2% and 90.1% vs 91.3% in the tumor capsule invasion subgroup; 26.3% vs 64.5%, 69.8% vs 78.4%, 87.4% vs 97.2% and 88.6% vs 98.1% in the vascular invasion subgroup; and 12.5% vs 31.2%, 36.4% vs 47.4%, 50.3% vs 60.1% and 56.8% vs 65.3% in the multiple nodules subgroup, respectively. The recurrence rates only significantly decreased at 6 months and 12 months in the group of patients after liver resection + adjuvant TACE (P<0.05). Among the patients who developed recurrence, the mean survival in these two groups was 25.3 vs 20.5 months, and the 1-, 2- and 3-year overall survival rates were 68.5% vs 50.3%, 49.3% vs 31.2% and 27.6% vs 20.3%, respectively all P<0.05. Furthermore, postoperative adjuvant TACE was effective in enhancing sensitivity of CT/MRI to detect <1 cm recurrent lesions. Conclusion Postoperative adjuvant TACE was effective in preventing, detecting and treating early recurrent HCC after liver resection. Key words: Liver cancer; Curative resection; Adjuvant TACE, postoperative; Early recurrence