Preoperative transcatheter arterial chemoembolization for resectable hepatocellular carcinoma: a single center analysis

Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 4

Abstract

Background and aim. The effect of preoperative transcatheter arterial chemoembolization (TACE) on the short- and long-term outcome of resectable hepatocellular carcinoma (HCC) is controversial. We conducted a retrospective evaluation of this aspect using data from our center. Material and methods. A total of 656 consecutive patients who underwent curative resection of HCC were divided into two groups based on the preoperative TACE: the liver resection (LR) group (405 cases) and the TACE-LR group (183 cases). Overall and disease-free survival curves were constructed using the Kaplan-Meier method and compared with the log-rank test. The significance of differences in survival was tested using a log-rank test. Univariate and multivariate analyses were used to identify the factors that best predicted overall survival or tumor free survival. Results. Although the cost of LR showed no difference between groups, the overall cost was significantly higher in the combined group than in the LR group (P < 0.001). The complication rate after resection was also comparable between the two groups. In regard to long-term outcome, the 1-, 3-, and 5-year overall survival rates were 83.7, 68.9 and 57.5%, respectively, after direct liver resection and 80.9, 65.0 and 54.1%, respectively, after combined TACE and resection (P = 0.739). The 1-, 3-, and 5-year recurrence- free survival rates were also comparable between two groups (P = 0.205). Both univariate analysis and multivariate analysis showed that macro-vascular invasion was the factor that best predicted overall survival or tumor-free survival rate. Conclusion. Preoperative TACE has comparable intraoperative and short-term outcomes but more overall cost due to repeated TACE, and the procedure did not significantly improve the overall or tumor-free survival rate. Preoperative TACE should not, therefore, be recommended as a routine procedure before resection for resectable HCCs particularly in cases due to underlying hepatitis B virus (HBV).

Authors and Affiliations

Jianyong L, Jinjing Z, Wentao W, Lunan Y, Qiao Z, Bo L, Tianfu W, Minqing X, Jiaying Y, Yongang W

Keywords

Related Articles

Epidemiologic trends in HBV infections at a reference centre in Turkey: an 11-year retrospective analysis

Objective. To identify changes in hepatitis B epidemiology after the implementation of the nationwide vaccination program in Turkey, hepatitis B virus (HBV) and related tests performed over a period of 11 years (2000-20...

Drug-induced liver injury in hospitalized HIV patients: high incidence and association with drugs for tuberculosis

Background. The evaluation of liver disease in HIV patients is cumbersome because may result from a number of different causes. The aim of this retrospective study was to estimate the incidence of severe drug induced liv...

Direct acting inhibitors of ammoniagenesis: a role in post-TIPS encephalopathy?

A limited number of medications are typically considered for the management of hepatic encephalopathy occurring as a complication of transjugular intrahepatic portosystemic shunt (TIPS) placement. Multiple alternative co...

Insulin resistance, hepatic steatosis and hepatitis C: A complex relationship with relevant clinical implications

Insulin resistance (IR) is a common pathophysiological condition where higher-than-normal concentrations of insulin are needed to maintain a normal glycemia and adequate glucose utilization in insulin target tissues. A h...

Do older patients utilize excess health care resources after liver transplantation?

Introduction. Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age ≥ 60 years) given the relative...

Download PDF file
  • EP ID EP78417
  • DOI -
  • Views 109
  • Downloads 0

How To Cite

Jianyong L, Jinjing Z, Wentao W, Lunan Y, Qiao Z, Bo L, Tianfu W, Minqing X, Jiaying Y, Yongang W (2014). Preoperative transcatheter arterial chemoembolization for resectable hepatocellular carcinoma: a single center analysis. Annals of Hepatology, 13(4), 394-402. https://europub.co.uk/articles/-A-78417