title: Efficacy of chemoembolization for recurrent HCC after curative ablation therapy.
abstract: OBJECTIVE
  Transarterial chemoembolization (TACE) is a widely applied standard treatment option for treatment-naïve patients with multifocal hepatocellular carcinoma (HCC). However, the treatment strategy in patients with multi-nodular recurrences has not been well addressed. This retrospective cohort study aimed to evaluate the efficacy of TACE for recurrent HCC.
  
  
  METHODS
  Two hundred seventeen consecutive patients who received curative ablation therapy for HCC were followed up. Forty-three of the 217 underwent TACE for recurrent HCC, and the treatment efficacy after TACE was compared with that in 99 treatment-naïve patients who underwent TACE for multifocal HCC during the same period.
  
  
  RESULTS
  The overall survival rates of the patients after TACE for recurrent HCC were not different (P=0.136) from those of the treatment-naïve patients after TACE. No serious adverse events related to TACE were observed in either group. Serum albumin levels (>3.5g/dL, p=0.001), alpha-fetoprotein levels (<300ng/mL, p=0.021), protein induced by vitamin K absence or antagonist II levels (<300ng/mL, p=0.045), and the number of recurrent tumors (<=3 nodules, p=0.047) were prognostic factors after TACE in patients with recurrent HCC.
  
  
  CONCLUSIONS
  TACE for multifocal recurrent HCC is safe and effective, with good survival results, similar to those of initial TACE for treatment-naïve patients with multifocal HCC.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Okabe
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kondo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Moriya
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality / Q000628:therapy*; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; C422455:ALB protein, human; D015415:Biomarkers; D011498:Protein Precursors; D012709:Serum Albumin; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin; D000075462:Serum Albumin, Human