Int J Gastrointest Interv.  2023 Nov;12(4):169-175. 10.18528/ijgii230025.

Preoperative transarterial chemoembolization does not improve the outcomes of resectable hepatocellular carcinoma: A propensity score-matched study

• Burasakarn P
• Hongjinda S
• Thienhiran A
• Phancharoenkit N
• Fuengfoo P

• KMID: 2547831
• DOI: http://doi.org/10.18528/ijgii230025

Abstract

Background
Transarterial chemoembolization (TACE) is reserved for the treatment of intermediate hepatocellular carcinoma (HCC) (Barcelona Clinic Liver Cancer stage B); however, it can also be utilized as a neoadjuvant treatment prior to surgical resection in resectable HCC cases. This study aimed to clarify the benefits of TACE in patients with resectable HCC.
Methods
Data were retrospectively collected from patients with resectable HCC who had undergone hepatectomy between January 2010 and December 2015. A 1:1 propensity-matched case-control study was conducted using a logistic regression model that included the following covariates: sex, age, Model for end-stage liver disease score, and the number and size of tumors.
Results
Of 160 patients, 37 and 123 were included in the TACE before liver resection (TACE-LR) and upfront LR groups, respectively. After 1:1 propensity score matching in the LR-matched group (n = 37), no significant differences in baseline parameters were found between the TACE-LR and LR-matched groups. Moreover, there were no significant differences in short-term outcomes, including intraoperative blood loss (800 mL vs. 500 mL, P = 0.148), operative time (300 min vs. 290 min, P = 0.824), and overall morbidity (24.3% vs. 13.51%, P = 0.235) between the TACE-LR and LRmatched groups. As long-term outcomes, no significant between-group differences were found in the 5-year disease-free survival rate (TACE-LR, 38%; LR, 58%; P = 0.89) or the 5-year overall survival rate (TACE-LR, 80.9%; LR, 80.8%; P = 0.72).
Conclusion
The short- and long-term outcomes were not significantly different between preoperative TACE and LR for resectable HCC.

Keyword

Carcinoma, hepatocellular; Chemoembolization, therapeutic; General surgery; Survival; Treatment outcome