4.6 Article

Lipiodolized transarterial chemoembolization in hepatocellular carcinoma patients after curative resection

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SPRINGER
DOI: 10.1007/s00432-012-1343-7

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Hepatocellular carcinoma; Curative resection; Lipiodolized transarterial chemoembolization; Survival; Recurrence

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To explore the effect of lipiodolized transarterial chemoembolization (lip-TACE) in hepatocellular carcinoma (HCC) patients at different risk of recurrence after curative resection. One thousand nine hundred and twenty-four consecutive HCC patients who underwent curative resection were retrospectively analyzed. Patients who underwent resection only were classified into control group, while those received adjuvant lip-TACE were classified into intervention group. Patients were further stratified into 4 groups, that is, tumor a parts per thousand currency sign5 cm with low or high risk factors, as well as tumor > 5 cm with low or high risk factors for recurrence. Tumor number and microscopic tumor thrombus were defined as risk factors for recurrence. The effect of adjuvant lip-TACE on early (< 2 year) or late (a parts per thousand yen2 year) recurrence was evaluated. There was no significant difference in recurrence curve between intervention group and control group in each stratum. Adjuvant lip-TACE showed an overall survival benefit in patients with tumor > 5 cm and presenting high risk factors, mainly for those with time to recurrence (TTR) < 2 years after operation. For them, the median survival was 17 months in the intervention group and 11 months in the control group (P = 0.010). For patients who were confirmed to be recurrence-free at 2 years after operation, it had the negative effect for survival (HR = 1.75, P = 0.004). Adjuvant lip-TACE had no preventive effect on recurrence, but may be of benefit to detect early recurrence.

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