[Appraisal of postoperative transcatheter arterial chemoembolization (TACE) for prevention and treatment of hepatocellular carcinoma recurrence].
OBJECTIVE
To evaluate the effect of postoperative TACE for prevention and treatment of hepatocellular carcinoma (HCC) recurrence after radical resection.


METHODS
From Jan. 1995 through March 1998, 109 HCC patients after radical resection were followed up with serum AFP, liver US and CT, chest X-ray film, hepatic artery angiography, etc. They were divided into 2 groups. Patients in group A (n = 68) with no residual tumor were given prophylactic TACE treatment, 1-2 times at the second and fifth month after operation. Patients in group B (n = 41) with residual tumor left were treated with regular TACE, once every 2 months. The 2 groups of patients were followed up for 6-45 months after operation.


RESULTS
In group A, the real curative resection rate was 62.4%. Tumor recurrence was found in 10 of the 68 patients, with a total recurrence rate of 14.7% within 3 years after radical resection. The 1-, 2-, and 3-year cumulative recurrence rate was 7.4%, 13.2% and 14.7%, respectively. The 1-, 2-, and 3-year survival rate was 100%, 93.4% and 85.7%, respectively, while that in group B was 78.1%, 57.7% and 57.7%, respectively. The differences between the 2 groups of patients were statistically significant. The predictive pathological factors hampering completeness of tumor resection were: tumor size > 5 cm, more than 2 tumor nodules, the presence of satellite nodules, tumor with partial or without encapsulation and tumor thrombus in portal vein. Hepatic artery angiography with LP-CT and maintenance of high serum AFP level were the most sensitive methods for detecting residual tumor after operation.


CONCLUSIONS
Post-operative TACE is very useful for prevention and treatment of HCC recurrence. It helps improve survival of surgically treated HCC patients.
Lin
Z
Z
Liver Cancer Institute, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
Ren
Z
Z
Xia
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D002648:Child; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011182:Postoperative Care; D016019:Survival Analysis; D016896:Treatment Outcome