Open Access<p>Adjuvant trans-arterial chemoembolization after hepatectomy significantly improves the prognosis of low-risk patients with R0-stage hepatocellular carcinoma</p>
Author(s) -
Hui Xie,
Shengtao Tian,
Li Cui,
Jieyu Yan,
Yanhua Bai,
Xiaohui Li,
Maoqiang Wang,
Fangfang Zhang,
Feng Duan
Publication year - 2019
Publication title -
cancer management and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.024
H-Index - 40
ISSN - 1179-1322
DOI - 10.2147/cmar.s195485
Subject(s) - hepatocellular carcinoma , adjuvant , medicine , stage (stratigraphy) , hepatectomy , gastroenterology , oncology , urology , surgery , resection , biology , paleontology
Background: Transcatheter arterial chemoembolization (TACE) is one of the local therapies most commonly used to treat intermediate-stage or advanced-stage hepatocellular carcinoma (HCC). However, the clinical benefits of PA-TACE (postoperative adjuvant TACE) for improving prognosis (progress-free survival [PFS] or overall survival [OS]) of low-risk HCC patients with R0-stage HCC after hepatectomy were not very clear. Methods: From January 2005 to December 2012, 180 patients who underwent hepatectomy for HCC treatment were enrolled in this study, and the follow-up of these patients was ended in December 2017. Among these patients, 102 patients were performed PA-TACE 1 month later after R0 hepatectomy and 78 patients without adjuvant TACE after R0 hepatectomy. Survival analysis was calculated using the Kaplan-Meier statistical method. Differences between survival curves of different groups were tested using the univariate log-rank test. Multivariate Cox model was used to search for independent prognostic factors for progression or death and to acquire the adjusted HR. Results: PA-TACE significantly improved the survival of HCC patients received surgical resection. The PFS (progress-free survival) of PA-TACE group (median PFS 52.0 months; 95% CI: 14.0-90.0) was significantly longer than the control group (median PFS 11.1 months; 95% CI: [7.9-14.3]; log-rank P <0.001); and the OS (in PA-TACE group (median OS 90.7 months; 95% CI: 84.4-97.0 months) was also much longer than that of control group (median OS 54.4 months; 95% CI: 38.2-70.6 months; log-rank p <0.001). Moreover, the benefits of PA-TACE are greater for low-risk patients than high-risk patients. Conclusion: In patients with HCC, PA-TACE can significantly prolong progression-free survival and long-term OS. For low-risk patients, the benefits might be greater.