Postoperative prophylactic transcatheter arterial chemoembolization on early recurrence in patients with hepatocellular carcinoma with microvascular invasion

Abstract

Objective To study the effects of postoperative prophylactic transcatheter arterial chemoembolization (TACE) on early recurrence (≤1 year) in patients with hepatocellular carcinoma (HCC) with microvascular invasion. Methods We collected the clinical data of HCC patients treated with radical hepatectomy from Cancer Hospital of Guangxi Medical University between January 2012 and December 2013, and 127 eligible cases with microvascular invasion were reviewed. According to the treatment with or without TACE, the patients were divided into hepatectomy alone group (groupⅠ, n=86) and combined with TACE group (group Ⅱ, n=41). The PSM (Propensity Score Matching) of SPSS software was used to reduce confounding bias between the two groups, and the disease free survival rates were compared between the matched data. Results Thirty-nine pairs were matched with PSM for balancing covariates in the two groups. The relapse-free survival rates of 4, 8 and 12-month were all significantly higher in the group Ⅱ (89.7%, 76.1%, 62.8%) than that in group Ⅰ (68.3%, 57.8%, 41.4%). There were significantly statistical differences (χ2=4.247, P<0.05). Cox regression analysis revealed serum AST level was an independent prognostic factor associated with poor early recurrence. Conclusion Prophylactic TACE after radical resection might have benefits in delaying early-onset recurrence for HCC patients with microvascular invasion. Key words: Hepatocellular carcinoma; Prophylactic transcatheter arterial chemoembolization; Early recurrence; Microvascular invasion