Preoperative Transcatheter Arterial Chemoembolization and Prognosis of Patients with Resectable Hepatocellular Carcinomas

Park, Min Ho; Cho, Chol Kyoon; Kim, Hyun Jong

Abstract

BACKGROUNDING/AIMS: Although several papers provided evidence of a survival advantage for preoperative transcatheter arterial chemoembolization(TAE), recent studies have revealed that patients with resectable tumors have not been benefited from this adjuvant therapy. This study has been done for investigating the effect of the preoperative TAE with resectable hepatocellular carcinoma(HCC) which were diagnosed and treated by surgery and surgery with TAE by analysis and comparison with patient's survival rate between two different methods of treatment.
METHODS
We retrospectively reviewed the medical records of 39 patients who underwent the hepatic resection for hepatocellular carcinoma at Chonnam National University Hospital between 1986 and 1997. Median follow-up period was 28 months. Survival rates were estimated by Kaplan-Meier method and difference was detected by Log-rank test using SPSS program..
RESULTS
Male patients were 28 and female were 11 and their mean age was 54.4 years. The patients treated by operation alone were 17 and by preoperative TAE with operation were 22. A reduction of tumor size was achived in 13 of the 22 patients(59.1%) who underwent preoperative TAE. The cumulative survival rate of 1 year, 2 year, 3 year were 90%, 84%, 70% in patients treated by operation alone, 86%, 75%, 52% in patients treated by preoperative TAE and operation respectively. And the relative risk of death for TAE with operation and operation alone was 0.974. The postoperative mean liver function test of the patients who underwent preoperative TAE was higher than those who did not.
CONCLUSIONS
The advantage of preoperative TAE with resectable HCC still remains disputable. However, preoperative TAE has the advantage of reducing tumor size and make it easy to operate and decrease the resection field. But the liver function after TAE may deteriorate in some of the patients with liver dysfunction. In conclusion, preoperative TAE must not be performed for resectable HCC as a routine procedure because the overall survival rate was similar between the two groups.