Postoperative adjuvant transcatheter arterial chemoembolization for hepatocellular carcinoma: a prospective study

Abstract

Objective To evaluate the clinical value of postoperative adjuvant transcatheter arterial chemoembolization(TACE) on the prognosis of hepatocellular carcinoma(HCC) patients after radical hepatectomy using a prospective cohort study.Methods A total of 220 HCC patients underwent radical hepatectomy from Jan.2008 to Dec.2008 and 104 were recruited in the present study.Fifty-six patients(TACE group) received adjuvant TACE one month after hepatectomy,and 48(control group) did not receive any adjuvant therapies.Follow-up was done regularly.The disease-free survival(DFS) time and total survival(TS) were statistically analyzed.Results The median DFS time in TACE group was significantly shorter than that in the control group(11 months vs 13 months,P=0.005).The 1-year,2-year and 3-year recurrence rates were 50%,85.7%,and 89.3% in TACE group and 46.8%,58.3%,and 62.5% in the control group(P=0.005),respectively.Multivariate COX regression analysis indicated that TACE,AFP,intact tumor peplos,liver cirrhosis,vascular invasion and tumor Edmondson-Steiner grade were the risk factors for recurrence(P0.05).The median TS time periods in TACE group and control group were 29(4-41) months and 24(5-59) months(P=0.789),respectively.The 1-year,2-year and 3-year survival rates were 85.6%,59.5%,and 36.5% in TACE group and 75%,50%,and 41.7% in the control group(P=0.789),respectively.Multivariate COX regression analysis indicated that AFP,intact tumor peplos and tumor Edmondson-Steiner grade were correlated with the total survival of patients(P0.05).Conclusion Adjuvant TACE can not improve DFS and TS of HCC patients after radical hepatectomy,and it may even contribute to a poor prognosis.Therefore more attention should be paid in choosing treatment strategy.