[The effect of preoperative transcatheter hepatic arterial chemoembolization on disease-free survival after hepatectomy for hepatocellular carcinoma].
OBJECTIVE
To analyse the effect of preoperative transcatheter hepatic arterial chemoembolization(TACE) on disease-free survival rate after surgical excision for hepatocellular carcinoma(HCC), in order to evaluate its therapeutic significance.


METHODS
The history of 1,457 cases of HCC with long term follow-up who received curative or relatively curative tumor resection was reviewed. Among these patients, 120 received preoperative TACE. Factors of prognostic significance were analysed using Cox proportional hazards survival mode, and the disease-free survival was analysed by Kaplan-Meier estimation.


RESULTS
Multivariate analysis revealed that the factors of prognostic significance were number and size of tumor mass and its gross type, number and efficacy of TACE treatment, presence of tumor thrombus, satellite nodules, vascular invasion, and postoperative AFP level. The 5-year disease-free survival rate following surgery of patients who received TACE twice or more was 51.0%, while that of patients who received TACE once and none was 35.5% and 21.4%, respectively. The mean disease-free suvival time in these 3 groups of patients was 66.4, 22.5 and 12.5 months, respectively. For patients whose TACE treatment was effective, the 5-year disease-free survival rate was 56.8%, with a mean disease-free suvival time of 90.1 months.


CONCLUSIONS
Preoperative TACE is so far the most feasible approach to improve disease-free survival of HCC patients.
Zhang
Z
Z
Easterm Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433.
Wu
M
M
Liu
Q
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged