J Cancer 2018; 9(16):2778-2785. doi:10.7150/jca.25033

Research Paper

Resection versus Resection with Preoperative Transcatheter Arterial Chemoembolization for Resectable Hepatocellular Carcinoma Recurrence

Qiang Tao1,2*, Wei He1,2*, Binkui Li1,2*, Yun Zheng1,2, Ruhai Zou1,3, Jingxian Shen1,4, Wenwu Liu1,2, Yuanping Zhang1,2, Yunfei Yuan1,2✉

1. State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
2. Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
3. Department of Ultrasound, Sun Yat-Sen University Cancer Center, Guangzhou, China
4. Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, China
* These authors contributed equally to this work.

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Citation:
Tao Q, He W, Li B, Zheng Y, Zou R, Shen J, Liu W, Zhang Y, Yuan Y. Resection versus Resection with Preoperative Transcatheter Arterial Chemoembolization for Resectable Hepatocellular Carcinoma Recurrence. J Cancer 2018; 9(16):2778-2785. doi:10.7150/jca.25033. Available from http://www.jcancer.org/v09p2778.htm

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Abstract

The value of preoperative transcatheter arterial chemoembolization (TACE) for patients with recurrent hepatocellular carcinoma (rHCC) after liver resection is uncertain. We aimed to determine its effect on postoperative complication and survival. There were 33 patients who received preoperative TACE and repeated liver resection (TACE-LR) and 119 patients who received repeated liver resection (LR) alone for rHCC. Seventy-eight patients (TACE-LR, 28; LR, 50) were identified by propensity score matching (PSM) analysis for comparison of postoperative complication, disease-free survival (DFS) and overall survival (OS). Univariable and multivariable analyses were used to identify predictors for survival. Before matching, the TACE-LR group had more intraoperative blood loss than the LR group (P < 0.05). After matching, the TACE-LR group had more intraoperative blood loss and a longer operation time (Both P < 0.05). In all and matched patients, both groups had similar postoperative complications rate (TACE-LR, 21.2%; LR, 7.6%; P = 0.052 and TACE-LR, 21.4%; LR, 12.0%; P = 0.435), DFS (P = 0.81 and P = 0.41) and OS (P = 0.87 and P = 0.79). Preoperative TACE was not a predictor for DFS and OS in multivariable analyses. Preoperative TACE for resectable rHCC prolongs operating time and increases intraoperative blood loss without improving survival; thus, it should not be recommended as a routine procedure before repeated resection for patients with rHCCs.

Keywords: Hepatocellular carcinoma, Recurrence, Liver resection, Transcatheter Arterial Chemoembolization.