Patient Survival And Tumour Recurrence With Transcatheter Arterial Chemoembolization After Hepatectomy For Hepatocellular Carcinoma: A Single-center Large Case Follow-up Study

Objective To explore the effects of TACE on the patients' survival and tumour recurrence after hepatectomy for HCC and analysis the influence factors of long-term survival short-term tumour recurrence rate and to find filtering conditions for whether to conduct TACE treatment after liver resection surgery. Methods We performed a retrospective analysis of patients in our center who had received liver resection due to HCC. Patients were divided into 2 groups:with (n=103) and without (n=118) TACE (control). Survival and tumour recurrence were calculated at years 1,2 and 3. The factors contributed to the Prognosis were analyzed by Cox regression. Results The 2 groups did not differ in sex, age, Hepatitis B virus infection, high or modest HCC differentiation, tumour diameter, vascular thrombosis, or TNM stage of tumour. Survival significantly differed between patients with and without TACE at 1,2 and 3 years after surgery:95.1%,65%,40.8% and 71.2%,40.7%,21.2%, respectively (P<0.01). The tumour recurrence rate significantly differed between patients with and without TACE at year 1 after surgery (22.3% vs. 40.7%) (P<0.01) but not at years 2 and 3. Cox proportional hazards model showed the degree of tumor differentiation (P=0.046, Exp (B)=2.447) and vascular thrombosis (P=0.042, Exp (B)=3.052) were the independent pathological factors of theshort-term tumour recurrence in patients with postoperative TACE, while the vascular thrombosis (P=0.022, Exp (B)=2.461) and gender (P=0.019, Exp (B)=2.276) were the independent pathological factors of long term survival in patients with postoperative TACE. Conclusions TACE treatment after hepatectomy for primary HCC can significantly improve long-term survival and lower the short-term tumour recurrence rate. The degree of tumor differentiation and vascular thrombosis were the independent pathological factors of the short-term tumour recurrence, while the vascular thrombosis and gender were the independent pathological factors of the long term survival in patients with postoperative TACE.