Korean J Hepatol.  2010 Dec;16(4):383-388. 10.3350/kjhep.2010.16.4.383.

Long-term outcome of preoperative transarterial chemoembolization and hepatic resection in patients with hepatocellular carcinoma

• Kang JY
• Choi MS
• Kim SJ
• Kil JS
• Lee JH
• Koh KC
• Paik SW
• Yoo BC

• KMID: 1117695
• DOI: http://doi.org/10.3350/kjhep.2010.16.4.383

Abstract

BACKGROUND/AIMS
Transarterial chemoembolization (TACE) improves the survival of patients with unresectable hepatocellular carcinoma (HCC) and has been recommended as a first-line therapy for nonsurgical patients with large or multifocal HCC. The long-term outcome of HCC patients receiving TACE prior to hepatic resection is uncertain.
METHODS
Between January 1997 and December 2007, 1,530 patients underwent hepatic resection for HCC at our center. Thirty-two patients received 1~12 sessions of TACE followed by surgical resection (TACE-surgery group). Their overall and recurrence-free survival rates were compared with those of 64 age- and sex-matched controls who underwent surgery only (surgery group). Overall and recurrence-free survival rates were analyzed.
RESULTS
The 1-, 2-, and 5-year overall survival rates did not differ significantly between the TACE-surgery group and the surgery group (78%, 60%, and 26%, respectively, vs. 97%, 83%, and 45%, respectively; P=0.11); however, the 1-, 2-, and 5-year recurrence-free survival rates were significantly lower in the TACE-surgery group than in the surgery group (58%, 36%, and 7%, respectively, vs. 77%, 58%, and 32%, respectively; P=0.01). The distribution of recurrence sites in the TACE-surgery group were intrahepatic in 85.7% and extrahepatic in 14.3%, and did not differ from those in the surgery group (91.4% and 8.6%, respectively; P=0.66).
CONCLUSIONS
HCC patients who underwent TACE before resection appear to have overall survival rates that are comparable to those without preoperative therapy, although recurrence rates appear to be higher in patients with TACE.

Keyword

Transarterial chemoembolization; Hepatocellular carcinoma; Preoperative; Surgery

MeSH Terms

Adult
Age Factors
Aged
Antibiotics, Antineoplastic/administration & dosage
Carcinoma, Hepatocellular/mortality/surgery/*therapy
Chemoembolization, Therapeutic
Disease-Free Survival
Doxorubicin/administration & dosage
Female
Hepatectomy
Hepatitis B/complications
Hepatitis C/complications
Humans
Liver Neoplasms/mortality/surgery/*therapy
Male
Middle Aged
Neoplasm Staging
Preoperative Care
Severity of Illness Index
Sex Factors
Survival Rate