Randomized controlled trial to compare the dose of adjuvant chemotherapy after curative resection of hepatocellular carcinoma.
OBJECTIVE
Adjuvant locoregional chemotherapy has been shown to be useful to prevent recurrence after curative resection of hepatocellular carcinoma (HCC) in some retrospective studies. Our aim was to compare the dose effect in the prevention of tumor recurrence.


METHODS
A prospective randomized controlled trial was conducted in patients with curative resection of HCC; they were given either one intra-arterial dose of cisplatin/lipiodol, or received four doses, once every 3 months. The rates of recurrence, disease-free and overall survival were compared.


RESULTS
During a median follow up of 818 days, 21 patients received one dose and 19 received four doses, with 10 (47.6%) and eight (42.1%) recurrences, respectively. The 1-year, 2-year and 3-year disease-free survival rates were 71%, 54% and 44% for the one-dose group and 74%, 60% and 40% for the four-dose group (P = 0.78). The respective overall survival rates were 85%, 74%, 55% and 84%, 71%, 40% (P = 0.64). The only prognostic factor was presence of vascular permeation. The side-effects were mild and tolerable.


CONCLUSIONS
There is no significant difference in the survival rates between the two groups. Adjuvant chemotherapy may not be useful.
Kwok
Philip Chong-Hei
PC
Departments of Radiology and Imaging, Queen Elizabeth Hospital, Kowloon, Hong Kong. pchkwok@ha.org.hk
Lam
Ting Wa
TW
Lam
Polly Woon-Yee
PW
Tang
Kwok Wai
KW
Chan
Susan Chi-Hum
SC
Hwang
James Shu-Tak
JS
Cheung
Moon Tong
MT
Tang
Donald Lap-Chiu
DL
Chung
Thomas Kam-Man
TK
Chia
Nam Hung
NH
Wong
Wong Kan
WK
Chan
Man Kwong
MK
Lo
Hong Yuen
HY
Lam
Wai Ming
WM
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage* / Q000627:therapeutic use*; D003287:Contrast Media / Q000008:administration & dosage; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007270:Injections, Intra-Articular; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011446:Prospective Studies; D015996:Survival Rate
D000970:Antineoplastic Agents; D003287:Contrast Media; D007459:Iodized Oil; D002945:Cisplatin