Adjuvant Transcatheter Arterial Chemoembolization After Radical Resection Of Hepatocellular Carcinoma Patients With Tumor Size Less Than 5cm

Background:Postoperative adjuvant transcatheter arterial chemoembolization is beneficial to prolong survival and decrease tumor recurrence.But the effect on small HCC is still unclear.Our aim is to evaluate the disease-free survival of adjuvant TACE after surgical resection on patients with tumor<5 cm,and in addition to find the factor affecting the tumor recurrence.Methods:307 patients with HCC underwent hepatic resection between January 2014 to December 2016 were enrolled in this study.Among these,172 patients underwent surgical treatment only(group A)and 135 patients received surgical resection followed by adjuvant TACE(group B).Propensity score matching(PSM)analysis is used to minimize baseline differences between two groups.DFS was compared between the two groups and Cox proportional hazard model was used to predict the factor for recurrence.Results:Before PSM,the 1,2,3 year DFS rate of group A and B were 90.1%,83.3%,75.3%versus 85.2%,73.9%,68.1%respectively(P=0.286).After PSM,the 1,2,3 year DFS rate of group A and group B were 90.3%,80.8%,71.9%versus 89.2%,77.8%,71.3%,respectively(P=0.791).In subgroup analysis where patients presented with microvascular invasion(MiVI),before PSM the 1,2,3 year DFS rate were 77.8%,77.8%,77.8%and 70%,70%,47.3%,for group A and B respectively(P=0.491).After PSM the 1,2,3 year DFS rate for group A and B were 71.4%,71.4%,71.4%and 100%,100%,50%,respectively(P=0.440).Cox proportional hazard model identified tumor size≥3cm as factor related to recurrence.Conclusion:Adjuvant TACE does not improve the DFS of HCC patients with tumor size less than 5 cm.