Transcatheter arterial chemoembolization combined with interferon-α is safe and effective for patients with hepatocellular carcinoma after curative resection.

Chaohui Zuo,Xiaohong Wang,Man Xia,Hanchun Liu,Ruocai Xu,Hua Xiao,Haizhen Zhu,Jianliang Li,Yongguo Li,Xiong Lei,Yuan Hong,Qunfeng Wu,Qinglong Li,Chen Liu,Michael Burns,Xiaoxin Qiu,Jingshi Liu

doi:10.7314/apjcp.2015.16.1.245

Abstract

Intrahepatic recurrence is the major cause of death among patients with hepatitis B virus (HBV)- related hepatocellular carcinoma (HCC) after curative surgical resection. Several approaches have been reported to decrease the recurrence rate. The objective of our study was to compare the clinical effects of transcatheter arterial chemoembolization (TACE) combined with interferon-alpha (IFN-α) therapy on recurrence after hepatic resection in patients with HBV-related HCC with that of TACE chemotherapy alone. We retrospectively analyzed the data from 228 patients who were diagnosed with HBV-related HCC and underwent curative resection between January 2001 to December 2008. The patients were divided into TACE (n = 126) and TACE-IFN-α (n = 102) groups for postoperative chemotherapy. The TACE regimen consisted of 5-fluorouracil (5-FU), cisplatin (DDP) , and the emulsion mixed with mitomycin C (MMC) and lipiodol. The recurrence rates, disease-free survival (DFS), overall survival (OS), and risk of recurrence were evaluated. The clinicopathological parameters and adverse effects were similar between the 2 groups (P > 0.05). The median OS for the TACE- IFN-α group (36.3 months) was significantly longer than that of the TACE group (24.5 months, P < 0.05). The 3-and 5-year OS for the TACE-IFN-α group were significantly longer than those of the TACE group (P < 0.05) and the recurrence rate was significantly lower (P < 0.05). The TACE and IFN-α combination therapy, active hepatitis HBV infection, the number of tumor nodules, microvascular invasion, liver cirrhosis, and the BCLC stage were independent predictors of OS and DFS. The use of the TACE and IFN-α combination chemotherapy after curative hepatic resection safely and effectively improves OS and decreases recurrence in patients with HBV-related HCC who are at high risk. Our findings can serve as a guide for the selection of postoperative adjuvant chemotherapy for patients with HBV-related HCC who are at high risk of recurrence.

Highlights

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide
The use of the transcatheter arterial chemoembolization (TACE) and IFN-α combination chemotherapy after curative hepatic resection safely and effectively improves overall survival (OS) and decreases recurrence in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who are at high risk
Our findings can serve as a guide for the selection of postoperative adjuvant chemotherapy for patients with HBV-related HCC who are at high risk of recurrence

Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. In 2008, an estimated 748, 300 new liver cancer cases and 695 900 cancer-related deaths occurred worldwide (Jemal et al, 2011). 50% of these incident cases and deaths occurred in China, among which over 90% of the incident patients were chronically infected with the hepatitis B virus (HBV) (Ferlay et al, 2010). Hepatic resection is still a major curative treatment for patients with HCC (Fan et al, 2011). The long-term prognosis of HCC patients following hepatic resection is poor because of the high rate of recurrence. Previous studies have reported a 5-year cumulative recurrence rate of 70% to 80% for HCC (Fina et al, 2012)

Objectives

Methods

Results

Conclusion