title: Long-term outcome of preoperative transarterial chemoembolization and hepatic resection in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Transarterial chemoembolization (TACE) improves the survival of patients with unresectable hepatocellular carcinoma (HCC) and has been recommended as a first-line therapy for nonsurgical patients with large or multifocal HCC. The long-term outcome of HCC patients receiving TACE prior to hepatic resection is uncertain.
  
  
  METHODS
  Between January 1997 and December 2007, 1,530 patients underwent hepatic resection for HCC at our center. Thirty-two patients received 1~12 sessions of TACE followed by surgical resection (TACE-surgery group). Their overall and recurrence-free survival rates were compared with those of 64 age- and sex-matched controls who underwent surgery only (surgery group). Overall and recurrence-free survival rates were analyzed.
  
  
  RESULTS
  The 1-, 2-, and 5-year overall survival rates did not differ significantly between the TACE-surgery group and the surgery group (78%, 60%, and 26%, respectively, vs. 97%, 83%, and 45%, respectively; P=0.11); however, the 1-, 2-, and 5-year recurrence-free survival rates were significantly lower in the TACE-surgery group than in the surgery group (58%, 36%, and 7%, respectively, vs. 77%, 58%, and 32%, respectively; P=0.01). The distribution of recurrence sites in the TACE-surgery group were intrahepatic in 85.7% and extrahepatic in 14.3%, and did not differ from those in the surgery group (91.4% and 8.6%, respectively; P=0.66).
  
  
  CONCLUSIONS
  HCC patients who underwent TACE before resection appear to have overall survival rates that are comparable to those without preoperative therapy, although recurrence rates appear to be higher in patients with TACE.
authors.affiliation: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ja Young
authors.initials: JY
authors.lastname: Kang
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Sue Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jae Sook
authors.initials: JS
authors.lastname: Kil
authors.forename: Joon Hyoek
authors.initials: JH
authors.lastname: Lee
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin