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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-04-2016 | Hepatobiliary Tumors

Postoperative Adjuvant Transcatheter Arterial Chemoembolization After R0 Hepatectomy Improves Outcomes of Patients Who have Hepatocellular Carcinoma with Microvascular Invasion

Authors: Jing Jian Sun, MD, Kang Wang, MD, Cun Zhen Zhang, MD, Wei Xing Guo, MD, Jie Shi, MD, Wen Ming Cong, MD, Meng Chao Wu, MD, Wan Yee Lau, MD, FRACS(Hon), Shu Qun Cheng, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2016

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Abstract

Background

Microvascular invasion (MiVI) is a major risk factor of survival outcomes after curative resection for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the impact of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) on HCC patients with MiVI.

Methods

From January 2004 to June 2013, HCC patients with histologically confirmed MiVI and well-tolerated liver function who underwent PA-TACE after R0 hepatectomy (RH) or RH alone were studied retrospectively. In the PA-TACE group, PA-TACE was given 4 weeks after RH. Uni- and multivariate analyses were used to identify the prognostic significance of PA-TACE.

Results

Of the 322 HCC patients with MiVI included in the analysis, 185 entered into the RH group and 137 entered into the PA-TACE group. The baseline characteristics of the two groups were similar except for alanine aminotransferase (ALT) level (p = 0.037). The 1-, 2-, 3-, and 5-year recurrence-free survival (RFS) rates were respectively 69.3, 55.5, 46.7, and 35.0 % for the PA-TACE group and 47.0, 36.2, 34.1, and 30.3 % for the RH group (log-rank, χ2 = 6.309; p = 0.012). The 1-, 2-, 3-, and 5-year overall survival (OS) rates were respectively 94.2, 78.8, 71.5, and 54.0 % for the PA-TACE group and 78.9, 62.2, 54.1, and 43.2 % for the RH group (log-rank, χ2 = 7.537; p = 0.006). Multivariate Cox proportional hazards regression analysis showed PA-TACE to be an independent risk factor of postoperative RFS and OS.

Conclusions

This study showed that PA-TACE may be beneficial for HCC patients with MiVI.
Appendix
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Metadata
Title
Postoperative Adjuvant Transcatheter Arterial Chemoembolization After R0 Hepatectomy Improves Outcomes of Patients Who have Hepatocellular Carcinoma with Microvascular Invasion
Authors
Jing Jian Sun, MD
Kang Wang, MD
Cun Zhen Zhang, MD
Wei Xing Guo, MD
Jie Shi, MD
Wen Ming Cong, MD
Meng Chao Wu, MD
Wan Yee Lau, MD, FRACS(Hon)
Shu Qun Cheng, MD, PhD
Publication date
01-04-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-5008-z

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