title: Chemoembolization of recurrent hepatoma after curative resection: prognostic factors.
abstract: OBJECTIVE
  The long-term prognosis after hepatic resection for the treatment of hepatocellular carcinoma (HCC) has been disappointing because of the high recurrence rates in the remnant liver, which constitutes the major cause of death. The purpose of this study was to identify the prognostic factors for overall survival after transarterial chemoembolization (TACE) in recurrent HCC after the initial curative surgical resection.
  
  
  METHODS
  From January 2003 through October 2012, 362 patients who developed recurrent HCC after initial surgical resection and underwent TACE as the first-line therapy were retrospectively studied at a single institution in our hospital. Patients who met our inclusion criteria were followed until December 2012. Prognostic factors for overall survival were analyzed.
  
  
  RESULTS
  In total, 287 patients were enrolled. The median overall survival period was 747 days. The 1-, 2-, and 3-year overall survival rates after TACE were 72.9%, 51.8%, and 31.8%, respectively. Multivariate analysis indicated that the number of resected HCCs (≥ 2, p < 0.001), the number (≥ 2, p < 0.001) and size (> 5 cm, p = 0.022) of the recurrent HCCs, and the number of TACE sessions (≤ 3, p < 0.001) are independent risk factors for poor survival after TACE for recurrent HCC after HCC resection.
  
  
  CONCLUSIONS
  TACE appears to be an effective treatment of patients who experienced a recurrence after curative HCC resection. An initial solitary HCC, a solitary recurrence, and recurrent tumor mass 5 cm or smaller are statistically significant independent prognostic factors for survival.
authors.affiliation: 1 Department of Radiology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Gulou District, Nanjing, Jiangsu 210029, China.
authors.forename: Qing-Quan
authors.initials: QQ
authors.lastname: Zu
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Chun-Gao
authors.initials: CG
authors.lastname: Zhou
authors.forename: Zheng-Qiang
authors.initials: ZQ
authors.lastname: Yang
authors.forename: Jin-Guo
authors.initials: JG
authors.lastname: Xia
authors.forename: Lin-Bo
authors.initials: LB
authors.lastname: Zhao
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Shi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000401:mortality*; D002681:China / Q000453:epidemiology; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: hepatic resection; hepatocellular carcinoma; prognostic factors; recurrence; transarterial chemoembolization