Xi Tao, Lai Eric C H, Min An-ru, Shi Le-hua, Wu Dong, Xue Feng, Wang Kui, Yan Zhenlin, Xia Yong, Shen Feng, Lau Wan Yee, Wu Meng-chao
Department of Comprehensive Treatment I, Second Military Medical University, Shanghai, China.
Hepatogastroenterology. 2012 Jun;59(116):1198-203. doi: 10.5754/hge09654.
BACKGROUND/AIMS: Prevention of recurrence is the most important strategy to improve long-term survival after resection of hepatocellular carcinoma (HCC). This comparative study aimed to evaluate the outcome of adjuvant transarterial chemoembolization (TACE) after hepatectomy.
From February 1996 and September 2001, 721 consecutive patients (adjuvant TACE treatment vs. control group; 145 vs. 576) with R0 resection for HCC were analyzed. The prospective data was analyzed retrospectively.
After a median follow-up of 75 months, 89 patients (61.4%) in the adjuvant TACE group and 355 patients (61.6%) in the control group had recurrent disease. There was no significant difference in the tumor recurrence rate between the 2 groups. There was significant difference in the tumor recurrence time between the 2 groups. The 1-, 3- and 5-year overall survival rates were 96.5%, 70.0% and 55.9%, respectively, for the adjuvant TACE group and 80.8%, 49.7% and 38.8%, respectively, for the control group. The 1-, 3- and 5-year disease-free survival rates were 79.9%, 54.9% and 48.4%, respectively, for the adjuvant TACE group and 60.2%, 39.8% and 31.5%, respectively, for the control group. The differences in the disease-free survival rates and the overall survival rates between the 2 groups were significant. In subgroup analysis, there was significant survival benefit in the adjuvant TACE group in the subgroup of patients with risk factors of recurrence - large tumor size, presence of satellite tumor nodules and narrow resection margin.
Adjuvant TACE improved surgical outcome in those patients with risk factors of HCC recurrence.
背景/目的：预防复发是提高肝细胞癌（HCC）切除术后长期生存率的最重要策略。本对比研究旨在评估肝切除术后辅助性经动脉化疗栓塞术（TACE）的效果。
对1996年2月至2001年9月期间连续721例行R0切除的HCC患者（辅助性TACE治疗组与对照组；145例与576例）进行分析。对前瞻性数据进行回顾性分析。
中位随访75个月后，辅助性TACE组89例患者（61.4%）和对照组355例患者（61.6%）出现疾病复发。两组间肿瘤复发率无显著差异。两组间肿瘤复发时间有显著差异。辅助性TACE组1年、3年和5年总生存率分别为96.5%、70.0%和55.9%，对照组分别为80.8%、49.7%和38.8%。辅助性TACE组1年、3年和5年无病生存率分别为79.9%、54.9%和48.4%，对照组分别为60.2%、39.8%和31.5%。两组间无病生存率和总生存率差异显著。在亚组分析中，在具有复发危险因素（肿瘤体积大、存在卫星肿瘤结节和手术切缘窄）的患者亚组中，辅助性TACE组有显著的生存获益。
辅助性TACE改善了具有HCC复发危险因素患者的手术效果。
