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01-10-2006

Postresectional Adjuvant Intraportal Chemotherapy in Patients with Hepatocellular Carcinoma: A Case-Control Study

Authors: Gar-Yang Chau, MD, MPH, Wing-Yiu Lui, MD, Shyh-Haw Tsay, MD, Yee Chao, MD, PhD, Kuang-Liang King, MD, Chew-Wun Wu, MD, FACS

Published in: Annals of Surgical Oncology | Issue 10/2006

Abstract

Background

The postresectional tumor recurrence rate is high in patients with hepatocellular carcinoma (HCC). Tumor portal venous invasion is the most important factor related to recurrence. Adjuvant intraportal infusion chemotherapy (IPIC) was used in HCC patients to improve the outcomes.

Methods

Between June 1998 and May 1999, 28 HCC patients (IPIC group) underwent postresectional IPIC daily for 2 days with 5-fluorouracil (650 mg/m²), leucovorin (45 mg/m²), doxorubicin (10 mg/m²), and cisplatin (20 mg/m²). Treatment was repeated every 3 weeks for six cycles. Patient outcomes were compared with those of 66 matched HCC patients (control group) who underwent hepatectomy without adjuvant therapy.

Results

The IPIC group received an average of 5.2 cycles of chemotherapy, starting 5 to 24 days after surgery. The most frequent IPIC-related adverse events were upper abdominal pain, vomiting, and myelosuppression. Five-year disease-free and overall survival rates for the IPIC group were 44.6% and 60.7%, respectively. Subgroup analysis of patients with tumor-node-metastasis stage I and II disease identified significantly lower recurrence rates for the IPIC group (33.3%) than the control group (65.0%; P = .025). For patients with stage I and II disease, 5-year disease-free and overall survival rates for the IPIC group (70.6% and 83.3%, respectively) were significantly higher than those of the control group (33.4% and 46.9%, respectively; P < .05). Patients with stage III disease do not benefit from IPIC.

Conclusions

Postoperative IPIC benefits HCC patients with tumor-node-metastasis stage I and II disease. The survival advantages demonstrated justify a selection of patients for future trials.

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Title: Postresectional Adjuvant Intraportal Chemotherapy in Patients with Hepatocellular Carcinoma: A Case-Control Study
Authors: Gar-Yang Chau, MD, MPH
Wing-Yiu Lui, MD
Shyh-Haw Tsay, MD
Yee Chao, MD, PhD
Kuang-Liang King, MD
Chew-Wun Wu, MD, FACS
Publication date: 01-10-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 10/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9004-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postresectional Adjuvant Intraportal Chemotherapy in Patients with Hepatocellular Carcinoma: A Case-Control Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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