title: Hepatic resection after transarterial chemoembolization increases overall survival in large/multifocal hepatocellular carcinoma: a retrospective cohort study.
abstract: To investigate the prognosis of transarterial chemoembolization (TACE) followed by hepatic resection (HR) in large/multifocal hepatocellular carcinoma (HCC), the medical records of consecutive HCC patients who underwent TACE between January 2006 and December 2010 were retrospectively analyzed. Patients who received TACE alone comprised the T group (61 patients), while those who received HR after TACE comprised the T+R group (49 patients). All the resections were successfully performed, and only one class V complication occurred. While liver function was altered from baseline within 1 week after HR, it recovered within 1 month. Overall survival (OS) of the T+R and T groups were compared, and sub-group analyses were performed based on baseline α-fetoprotein (AFP) levels, the reduction of AFP, and tumor response before HR. Overall survival (OS) in the T+R group was longer than in the T group (47.00 ± 2.87 vs. 20.00 ± 1.85 months, P < 0.001). OS in the T+R group with AFP reduction was less than 50%, and OS among those with a poor tumor response before HR did not differ from the T group (P > 0.05). These patients may not benefit from the combined treatment. Our findings suggest HR after TACE is safe and effective for large/multifocal HCC, and prolongs OS when compared to TACE alone.
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.|Department of Interventional Radiology, Ling-nan Hospital, Guangzhou, 510530 China.
authors.forename: Junwei
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180 China.
authors.forename: Lisha
authors.initials: L
authors.lastname: Lai
authors.affiliation: Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510180 China.
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.|Department of Interventional Radiology, Ling-nan Hospital, Guangzhou, 510530 China.
authors.forename: Wensou
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.
authors.forename: Mingyue
authors.initials: M
authors.lastname: Cai
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.|Interventional Radiology Institute, Sun Yat-Sen University, Guangzhou, 510630 China.
authors.forename: Kangshun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 China.|Department of Interventional Radiology, Ling-nan Hospital, Guangzhou, 510530 China.|Interventional Radiology Institute, Sun Yat-Sen University, Guangzhou, 510630 China.
authors.forename: Mingsheng
authors.initials: M
authors.lastname: Huang
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality* / Q000628:therapy*; D057785:Catheters; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D004317:Doxorubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000970:Antineoplastic Agents; D000509:alpha-Fetoproteins; D004998:Ethiodized Oil; D004317:Doxorubicin
keywords: hepatic resection; hepatocellular carcinoma; prognostic factors; transarterial chemoembolization