Preoperative adjuvant transarterial chemoembolization cannot improve the long term outcome of radical therapies for hepatocellular carcinoma.
Combinations of transarterial chemoembolization (TACE) and radical therapies (pretransplantation, resection and radiofrequency ablation) for hepatocellular carcinoma (HCC) have been reported as controversial issues in recent years. A consecutive sample of 1560 patients with Barcelona Clinic Liver Cancer (BCLC) stage A/B HCC who underwent solitary Radiofrequency ablation (RFA), resection or liver transplantation (LT) or adjuvant pre-operative TACE were included. The 1-, 3- and 5-year overall survival rates and tumor-free survival rates were comparable between the solitary radical therapy group and TACE combined group in the whole group and in each of the subgroups (RFA, resection and LT) (P > 0.05). In the subgroup analysis, according to BCLC stage A or B, the advantages of adjuvant TACE were also not observed (P > 0.05). A Neutrophil-lymphocyte ratio (NLR) more than 4, multiple tumor targets, BCLC stage B, and poor histological grade were significant contributors to the overall and tumor-free survival rates. In conclusions, our results indicated that preoperative adjuvant TACE did not prolong long-term overall or tumor-free survival, but LT should nevertheless be considered the first choice for BCLC stage A or B HCC patients. Radical therapies should be performed very carefully in BCLC stage B HCC patients.
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.|Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, China.
Lei
L
Jianyong
Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China.
Zhong
Z
Jinjing
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Yan
Y
Lunan
Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, China.
Zhu
Z
Jingqiang
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Wang
W
Wentao
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Zeng
Z
Yong
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Li
L
Bo
Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Wen
W
Tianfu
Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, China.
Yang
Y
Jiaying
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation; D002423:Cause of Death; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome