title: Adjuvant hepatic arterial infusion chemotherapy after hepatic resection of hepatocellular carcinoma with macroscopic vascular invasion.
abstract: BACKGROUND
  The prognosis of hepatocellular carcinoma (HCC) with macroscopic vascular invasion is extremely poor even after hepatic resection. We aimed to clarify the efficacy of adjuvant hepatic arterial infusion chemotherapy (HAI) for HCC with vascular invasion.
  
  
  METHODS
  A total of 73 HCC patients with macroscopic vascular invasion were divided into two groups: 38 with hepatectomy with HAI (HAI group) and 35 with hepatectomy alone (non-HAI group). From 1997 to 2007, HAI was performed via an implanted injection port. The treatment comprised three courses of weekly infusion of HAI, which comprised cisplatin (10 mg daily on days 1-5) followed by 5-fluorouracil (5-FU; 250 mg daily on days 1-5) infusion. From 2007, cisplatin (60 mg/m(2)), 5-FU (600 mg/m(2)), and a mixture of mitomycin C (3 mg/m(2)) and degradable starch microspheres were administered for two courses.
  
  
  RESULTS
  Overall, 92 % of patients completed adjuvant HAI. In the HAI and non-HAI groups, the 5-year disease-free survival (DFS) rates were 33.1 % and 11.8 %, respectively (p = 0.029), and the 5-year overall survival (OS) rates were 46.7 % and 32.7 %, respectively (p = 0.318). Among the patients with Vp3/4 or Vv3 (n = 32) in the HAI group, the 3-year DFS and OS rates were 33.7 % and 56.8 %, respectively (p = 0.049). Those in the non-HAI group were 8.3 % and 12.0 %, respectively (p = 0.023). Cox proportional multivariate analysis for DFS revealed that HAI was an independent favorable prognostic factor in all 73 patients (hazard ratio 0.536; p = 0.029).
  
  
  CONCLUSIONS
  Adjuvant HAI for HCC patients with vascular invasion might reduce the risk of recurrence.
authors: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Medical School Hospital, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. hnitta5085@gmail.com
authors: Hidetoshi
authors: H
authors: Nitta
authors: Toru
authors: T
authors: Beppu
authors: Katsunori
authors: K
authors: Imai
authors: Hiromitsu
authors: H
authors: Hayashi
authors: Akira
authors: A
authors: Chikamoto
authors: Hideo
authors: H
authors: Baba
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006498:Hepatectomy; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil