| Objective The long-term prognosis for the treatment after hepatectomy of hepatocellular carcinoma (HCC) patients has been disappointing because of the high recurrence rates in the remnant liver, which constitutes the major cause of death. The purpose of this study is to investigate the prognostic factors for overall survival after transcatherter arterial chemoembolization (TACE) in recurrent HCC after the initial surgical resection, and to provide a theoretical basis for clinicians to select reasonable treatment of recurrence in patients with hepatocellular carcinoma.Methods From January 2008 to October 2014,435 patients who developed recurrent HCC after initial surgical resection were consecutively admitted to our hospital. After the collation of data on patients, a total of 191 patients with postoperative HCC had intrahepatic recurrence underwent TACE treatment, in which,35 patients were performed with TACE combined with other treatment, and 8 patients who lost follow-up were excluded from the group. There were 148 patients who underwent TACE as the first-line therapy met our inclusion criteria, and they were retrospectively studied at a single institution in our hospital. Of them, the clinical features, laboratory, imaging findings, treatment methods and follow-up results were collected and recorded for classifying the related factors. The survival curves of the postoperative recurrence patients were plotted by Kaplan-Meier method. The possible factors of overall survival relative to prognosis of patients were screened by using the log-rank test. The Cox regression model was used to evaluate independent prognostic factors for affecting the TACE treatment of recurrent HCC.Results One hundred and forty-eight patients (128 male and 20 female) who had postresection HCC recurrent underwent TACE treatment were included for this study. They were 21 to 77 years old, and the average age was 514±11.5 years old, and the median follow-up time from initial resection of HCC to the time of follow-up was 38 months (range:3-95 months). All enrolled patients after first TACE treatment the overall 1-year,3-year, and 5-year survival rates were 75.9%,42.3% and 27.0%, respectively, the median survival time was 29 months (range 1～85 months), As to the follow-up time, all enrolled patients were performed TACE treatment total number 481, the median number of treatment was 4 (range:1-10), and none of the deaths occurred in within 30 days after TACE treatment. Log-rank test showed that the gender, hepatitis B virus carrier, vascular invasion, liver function Child-pugh class and hepatocellular carcinoma Edmondson-Steiner classification on prognosis of TACE treatment of post-resection recurrent HCC was not statistically significant, however, the recurrence AFP[positive (66.89,99/148) vs negative (33.11%,49/148), P=0.002], number of recurrent HCCs [＞3 (16.89%,25/148) vs≤3 (83.11%,123/148), P=0.003], Size of recurrent HCC [＞3cm (55.41%,82/148) vs≤3cm (44.59%,66/148,P＜0.001],time to recurrence [≤6 months (67.57%,100/148) vs＞6 month (32.43%,48/148), P=0.003] results have statistical significance. The multivariate analysis was introduced by using Cox regression model. The results showed that the recurrence of AFP positive, size of recurrent HCC＞3cm, time to recurrence≤6 months is independent prognostic risk factors which affect postoperative TACE in the treatment of recurrent HCC after surgical resection (P＜0.05).Conclusion (1)TACE appears to be an reasonable and effective treatment for recurrent HCC after resection, which can prolong the overall survival rate in those patients. (2)The independent risk factors influencing the prognosis of postoperative TACE treatment of recurrent HCC after surgical resection include:recurrence of AFP positive, size of recurrent HCC＞3 cm and time to recurrence≤6 months. |
PDF Full Text Request