title: Transarterial chemoembolization for intrahepatic multiple recurrent HCC after liver resection or transplantation.
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) can reduce tumor progression and help achieve good locoregional effect in hepatocellular carcinoma (HCC) patients with intrahepatic multiple recurrence (IHMR) after liver resection (LR). The effect of TACE on HCC patients with IHMR after liver transplantation (LT) remains unclear. The purpose of this study was to investigate the effect of TACE on IHMR after LR or LT.
  
  
  METHODS
  This hospital-based retrospective study included 968 and 180 HCC patients who had undergone LR or LT, respectively, in the past decade. Parameters included clinical characteristics, alpha-fetoprotein level, Child classification, tumor stage at first treatment, tumor size at recurrence, and recurrence and survival status. The groups were compared using the t test or chi-square test, and univariate and multivariate analyses were performed. Survival and recurrence were analyzed by the Kaplan-Meier method. Differences were significant at P<0.05.
  
  
  RESULTS
  During follow-up, 112 patients had IHMR: 101 after LR and 11 after LT. Age, sex distribution, and HCV infection rate differed significantly between the LR and LR groups. All patients in the LT group who had recurrent HCC died within 3 years. The risk factors for death from tumor recurrence included a larger tumor size at recurrence, poor Child classification at recurrence, hyperbilirubinemia, hypoalbuminemia, and no TACE treatment. In Cox regression analysis, only vessel invasion, Child class C, and no TACE treatment were independent risk factors for death from tumor recurrence.
  
  
  CONCLUSIONS
  TACE is beneficial for treating IHMR in patients after LR or LT.
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Yi-Chiao
authors: YC
authors: Cheng
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Teng-Wei
authors: TW
authors: Chen
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Hsiu-Lung
authors: HL
authors: Fan
authors: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Chih-Yung
authors: CY
authors: Yu
authors: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
authors: Heng-Cheng
authors: HC
authors: Chang
authors: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors: Chung-Bao
authors: CB
authors: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome