Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study
Background: More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains uncle...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-06-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2021.2021334 |
| _version_ | 1827817181677617152 |
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| author | Guifang Zeng Baojia Zou Yongliang Li En Lin Xialei Liu Peiping Li Jiafan Chen Baimeng Zhang Yingbin Jia Chaonong Cai Jian Li |
| author_facet | Guifang Zeng Baojia Zou Yongliang Li En Lin Xialei Liu Peiping Li Jiafan Chen Baimeng Zhang Yingbin Jia Chaonong Cai Jian Li |
| author_sort | Guifang Zeng |
| collection | DOAJ |
| description | Background: More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. Methods: Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. Results: Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (P = 0.977) but worse DFS compared with the No TACE group (P = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (P = 0.466, P = 0.864, P = 0.488, respectively) but even worse DFS (P = 0.035, P = 0.040, P = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (P = 0.342, P = 0.941, respectively). Conclusions: PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml. |
| first_indexed | 2024-03-12T00:30:45Z |
| format | Article |
| id | doaj.art-f56d892aa83d448bb050c49d89ce9436 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:30:45Z |
| publishDate | 2022-06-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of Investigative Surgery |
| spelling | doaj.art-f56d892aa83d448bb050c49d89ce94362023-09-15T10:21:29ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-06-013561208121610.1080/08941939.2021.20213342021334Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective StudyGuifang Zeng0Baojia Zou1Yongliang Li2En Lin3Xialei Liu4Peiping Li5Jiafan Chen6Baimeng Zhang7Yingbin Jia8Chaonong Cai9Jian Li10Department of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Pathology, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen UniversityBackground: More and more studies have suggested that hepatocellular carcinoma (HCC) patients with high-risk recurrence factors can benefit the most from postoperative adjuvant transarterial chemoembolization (PA-TACE) for its potential effect in delaying cancer recurrence. However, it remains unclear if solitary HCC (SHCC) patients particularly those without high-risk recurrence factors should also receive PA-TACE. This study aimed to analyze the efficacy of PA-TACE in them. Methods: Retrospectively, we enrolled 123 SHCC patients who either received radical hepatectomy alone (No TACE group, n = 39) or followed by PA-TACE (PA-TACE group, n = 84) in our institution. Prognostic risk factors, disease-free survival (DFS), and overall survival (OS) were analyzed using the Cox proportional hazard regression model, the Kaplan-Meier method, and the log-rank test. Results: Liver cirrhosis was the only independent risk factor for SHCC patients. Overall, the PA-TACE group had no improved OS (P = 0.977) but worse DFS compared with the No TACE group (P = 0.045). Consistently, in subgroup analysis, SHCC patients with negative microvascular invasion (MVI), tumor size ≤ 5 cm and preoperative alpha-fetoprotein (AFP) < 400 ng/ml had similar OS (P = 0.466, P = 0.864, P = 0.488, respectively) but even worse DFS (P = 0.035, P = 0.040, P = 0.019, respectively) than those in the No TACE group. Besides, there was no significant difference in DFS and OS between the two groups of SHCC patients with liver cirrhosis (P = 0.342, P = 0.941, respectively). Conclusions: PA-TACE may not improve the long-term survival of SHCC patients, but may even potentially promote their postoperative tumor recurrence, especially for those with MVI-negative, tumor size ≤ 5 cm, and preoperative AFP < 400 ng/ml.http://dx.doi.org/10.1080/08941939.2021.2021334solitary hepatocellular carcinoma (shcc)postoperative adjuvant transarterial chemoembolization (pa-tace)radical hepatectomyhigh-risk recurrence factors |
| spellingShingle | Guifang Zeng Baojia Zou Yongliang Li En Lin Xialei Liu Peiping Li Jiafan Chen Baimeng Zhang Yingbin Jia Chaonong Cai Jian Li Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study Journal of Investigative Surgery solitary hepatocellular carcinoma (shcc) postoperative adjuvant transarterial chemoembolization (pa-tace) radical hepatectomy high-risk recurrence factors |
| title | Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study |
| title_full | Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study |
| title_fullStr | Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study |
| title_full_unstemmed | Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study |
| title_short | Efficacy of Adjuvant Transarterial Chemoembolization after Radical Hepatectomy in Solitary Hepatocellular Carcinoma Patients: A Retrospective Study |
| title_sort | efficacy of adjuvant transarterial chemoembolization after radical hepatectomy in solitary hepatocellular carcinoma patients a retrospective study |
| topic | solitary hepatocellular carcinoma (shcc) postoperative adjuvant transarterial chemoembolization (pa-tace) radical hepatectomy high-risk recurrence factors |
| url | http://dx.doi.org/10.1080/08941939.2021.2021334 |
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