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Postoperative Adjuvant Transcatheter Arterial Chemoembolization After R0 Hepatectomy Improves Outcomes of Patients Who have Hepatocellular Carcinoma with Microvascular Invasion

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Microvascular invasion (MiVI) is a major risk factor of survival outcomes after curative resection for patients with hepatocellular carcinoma (HCC). This study aimed to investigate the impact of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) on HCC patients with MiVI.

Methods

From January 2004 to June 2013, HCC patients with histologically confirmed MiVI and well-tolerated liver function who underwent PA-TACE after R0 hepatectomy (RH) or RH alone were studied retrospectively. In the PA-TACE group, PA-TACE was given 4 weeks after RH. Uni- and multivariate analyses were used to identify the prognostic significance of PA-TACE.

Results

Of the 322 HCC patients with MiVI included in the analysis, 185 entered into the RH group and 137 entered into the PA-TACE group. The baseline characteristics of the two groups were similar except for alanine aminotransferase (ALT) level (p = 0.037). The 1-, 2-, 3-, and 5-year recurrence-free survival (RFS) rates were respectively 69.3, 55.5, 46.7, and 35.0 % for the PA-TACE group and 47.0, 36.2, 34.1, and 30.3 % for the RH group (log-rank, χ2 = 6.309; p = 0.012). The 1-, 2-, 3-, and 5-year overall survival (OS) rates were respectively 94.2, 78.8, 71.5, and 54.0 % for the PA-TACE group and 78.9, 62.2, 54.1, and 43.2 % for the RH group (log-rank, χ2 = 7.537; p = 0.006). Multivariate Cox proportional hazards regression analysis showed PA-TACE to be an independent risk factor of postoperative RFS and OS.

Conclusions

This study showed that PA-TACE may be beneficial for HCC patients with MiVI.

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Acknowledgments

This work was supported by grants of the Science Fund for Creative Research Groups (No. 81221061), The State Key Project on Diseases of China (2012zx10002016016003), The China National Funds for Distinguished Young Scientists (no. 81125018), Chang Jiang Scholars Program (2013) of China Ministry of Education, The National Key Basic Research Program “973 Project” (No. 2015CB554000), The New Excellent Talents Program of Shanghai Municipal Health Bureau (No. XBR2011025), Shanghai Science and Technology Committee (No. 134119a0200), and SMMU Innovation Alliance for Liver Cancer Diagnosis and Treatment (2012).

Disclosures

There are no conflicts of interest.

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    Authors and Affiliations

    1. Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai, 200433, China

      Jing Jian Sun MD, Kang Wang MD, Cun Zhen Zhang MD, Wei Xing Guo MD, Jie Shi MD, Meng Chao Wu MD, Wan Yee Lau MD, FRACS(Hon) & Shu Qun Cheng MD, PhD

    2. Department of Pathology, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China

      Wen Ming Cong MD

    3. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

      Wan Yee Lau MD, FRACS(Hon)

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    Correspondence to Shu Qun Cheng MD, PhD.

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    Jing Jian Sun, Kang Wang, and Cun Zhen Zhang have contributed equally to this work.

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    Sun, J.J., Wang, K., Zhang, C.Z. et al. Postoperative Adjuvant Transcatheter Arterial Chemoembolization After R0 Hepatectomy Improves Outcomes of Patients Who have Hepatocellular Carcinoma with Microvascular Invasion. Ann Surg Oncol 23, 1344–1351 (2016). https://doi.org/10.1245/s10434-015-5008-z

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