Factors Associated with Recurrence of Hepatocellular Carcinoma in 197 Patients Following Transarterial Chemoembolization: A Retrospective Study from a Single Center.

BACKGROUND Hepatocellular carcinoma (HCC) is the second leading cause of cancer deaths. Transarterial chemoembolization (TACE) has been widely applied for treating patients with unresectable HCC. This study explored the factors influencing early recurrence (ER) after TACE in HCC patients. MATERIAL AND METHODS A total of 197 patients were divided into the ER group and the non-ER group. Univariate and multivariate Cox regression analyses were carried out to explore the influencing factors. Univariate Kaplan-Meier survival curves and restricted cubic splines were plotted for visualizing the relations between the influencing factors and ER. RESULTS According to the multivariate analysis, for every 1-cm increase in the maximum tumor diameter, the risk of ER increased by 0.235 times (95% CI: 1.144-1.333, P<0.001). Patients with adjacent lobe invasion had a 1.227-fold higher risk of ER than those without (95% CI: 1.461-3.394, P<0.001). For every unit increase in neutrophil-to-lymphocyte ratio (NLR), the risk increased by 0.107-fold (95% CI: 1.012-1.211, P=0.027). Compared to patients at the very early/early Barcelona clinic liver cancer (BCLC) stage, those at the advanced/end stage had a 2.045-fold increased risk of ER (95% CI: 1.259-7.366, P=0.014). CONCLUSIONS The maximum tumor diameter, adjacent lobe invasion, NLR, and advanced/end stage BCLC stage were all risk factors for ER after TACE in HCC patients.