title: Adjuvant transarterial chemoembolization after curative resection of hepatocellular carcinoma: a non-randomized comparative study.
abstract: OBJECTIVE
  Prevention of recurrence is the most important strategy to improve long-term survival after resection of hepatocellular carcinoma (HCC). This comparative study aimed to evaluate the outcome of adjuvant transarterial chemoembolization (TACE) after hepatectomy.
  
  
  METHODS
  From February 1996 and September 2001, 721 consecutive patients (adjuvant TACE treatment vs. control group; 145 vs. 576) with R0 resection for HCC were analyzed. The prospective data was analyzed retrospectively.
  
  
  RESULTS
  After a median follow-up of 75 months, 89 patients (61.4%) in the adjuvant TACE group and 355 patients (61.6%) in the control group had recurrent disease. There was no significant difference in the tumor recurrence rate between the 2 groups. There was significant difference in the tumor recurrence time between the 2 groups. The 1-, 3- and 5-year overall survival rates were 96.5%, 70.0% and 55.9%, respectively, for the adjuvant TACE group and 80.8%, 49.7% and 38.8%, respectively, for the control group. The 1-, 3- and 5-year disease-free survival rates were 79.9%, 54.9% and 48.4%, respectively, for the adjuvant TACE group and 60.2%, 39.8% and 31.5%, respectively, for the control group. The differences in the disease-free survival rates and the overall survival rates between the 2 groups were significant. In subgroup analysis, there was significant survival benefit in the adjuvant TACE group in the subgroup of patients with risk factors of recurrence - large tumor size, presence of satellite tumor nodules and narrow resection margin.
  
  
  CONCLUSIONS
  Adjuvant TACE improved surgical outcome in those patients with risk factors of HCC recurrence.
authors.affiliation: Department of Comprehensive Treatment I, Second Military Medical University, Shanghai, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xi
authors.forename: Eric C H
authors.initials: EC
authors.lastname: Lai
authors.forename: An-ru
authors.initials: AR
authors.lastname: Min
authors.forename: Le-hua
authors.initials: LH
authors.lastname: Shi
authors.forename: Dong
authors.initials: D
authors.lastname: Wu
authors.forename: Feng
authors.initials: F
authors.lastname: Xue
authors.forename: Kui
authors.initials: K
authors.lastname: Wang
authors.forename: Zhenlin
authors.initials: Z
authors.lastname: Yan
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
authors.forename: Wan Yee
authors.initials: WY
authors.lastname: Lau
authors.forename: Meng-chao
authors.initials: MC
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D015996:Survival Rate