Surgery combined with post-operative trancatheter arterial chemoembolization improves survival of intermediate hepatocellular carcinoma

Scand J Gastroenterol. 2019 Feb;54(2):240-245. doi: 10.1080/00365521.2019.1577487. Epub 2019 Mar 17.

Abstract

Aim: To investigate the efficacy of surgery combined with post-operative trancatheter arterial chemoembolization (TACE) for intermediate hepatocellular carcinoma (HCC).

Methods: A total of 102 patients were divided into two groups: Radical liver resection only (LR group, 52 patients) and radical liver resection combined with post-operative TACE (combined group, 50 patients). Survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate analysis were performed using Cox proportional analysis to detect prognostic factors of survival outcomes.

Results: The 1-, 3- and 5-year survival rate in the LR group were significantly lower compared with those in combined group (p = .019). The 1-, 3- and 5-year progression-free survival rate in the LR group were also lower than those in the combined group (p = .048). Multivariate analysis detected that tumor number (multiple vs single), tumor distribution (both lobes vs semi-liver), treatment strategy (surgery + TACE vs surgery) were independent factors for OS (HR values were 2.307, 3.155 and 0.526, respectively) and PFS (HR values were 1.938, 3.425 and 0.633, respectively; p < .05).

Conclusion: In conclusion, surgery combined with post-operative TACE may improve survival outcomes for patients with intermediate HCC. Tumor number, tumor distribution and treatment strategy (surgery + TACE) were significantly associated with the prognosis of patients with intermediate HCC.

Keywords: Surgery; TACE; intermeidate HCC; survival.

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic*
  • China
  • Combined Modality Therapy
  • Female
  • Hepatectomy*
  • Humans
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Postoperative Period
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome