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The effect of preoperative transarterial chemoembolization of resectable hepatocellular carcinoma on clinical and economic outcomes
Author(s) -
Lee KingTeh,
Lu YiWei,
Wang ShenNien,
Chen HongYaw,
Chuang ShihChang,
Chang WenTsan,
Shi HonYi,
Ker ChenGuo,
Chiu HerngChia
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21248
Subject(s) - medicine , hepatocellular carcinoma , multivariate analysis , carcinoma , gastroenterology , overall survival , proportional hazards model , surgery
Background Hepatocellular carcinoma (HCC) is one of the most malignant cancers in the world. The effect of preoperative transarterial chemoembolization (TACE) for resectable HCC is still controversial and cost‐associated treatments are unknown. Methods We retrospectively compared clinical outcomes and resource utilization after liver resection between patients who underwent preoperative TACE (TACE‐LR group, n = 114) and those who did not (LR group, n = 236). Results The overall mortality rate was 27.54% for the LR group versus 39.47% for the TACE‐LR group ( P < 0.05). The overall recurrent rates were 29.36% for the LR group versus 35.90% for the TACE‐LR group ( P > 0.05). Multivariate Cox regression analysis showed that preoperative TACE was a significant risk factor ( P = 0.002, HR = 1.995, 95% CI 1.297–3.069) for overall long‐term survival for HCC. The TACE‐LR group had longer mean lengths of stay and higher hospital charges, both at index hospitalization and at 6 months for follow‐up. Conclusion Preoperative TACE is not only associated with higher medical utilizations, but it is also correlated with higher mortality rates over a 5‐year period. The preoperative TACE does not benefit patients with resectable HCC. The golden standard or clinical guidelines should be developed to provide better clinical decisions and decision support for HCC patients. J. Surg. Oncol. 2009;99:343–350. © 2009 Wiley‐Liss, Inc.