Efficacy Of Preventive TACE On Early Recurrent Of Small Hepatocellular Carcinoma With MVI After Radical Hepatectomy

Objective:To investigate the treatment of preventive Transcatheter Arterial Chemoembo- lization(TACE) on early recurrence of small Hepatocellular carcinoma patients with Microvascular invasion(MVI)after radical hepatectomy. In order to provide reference for clinical treatment of Hepatocellular carcinoma. Methods:The clinical data of 74 patients was collected from Department of Hepatobiliary Surgery of First Affiliated Hospital of Fujian Medical University and Mengchao Hepatobiliary Hospital of Fujian Medical University from January 1, 2010 to December 31, 2014, who had underwent radical hepatectomy, and the postoperative pathology confirmed MVI with small Hepatocellular carcinoma(the tumor size between 2cm to 5cm).Among them, preventive TACE treatment was performed in 42 patients who had underwent radical resection(TACE group), while preventive TACE treatment was not performed in 32 patients after radical resection. We collected the general pathological data of two groups of patients(such as: sex, age, serum AFP level, hepatitis B infection, and cirrhosis of the liver, liver tumor capsule, preoperative alanine aminotransferase, preoperative glutamate aminotransferase, albumin before operation, preoperative total bilirubin, intraoperative hepatic portal blocking time, intraoperative blood transfusion, operative time, postoperative tumor at Edmonson grade) and the disease free survival(DFS) of patients after operation within 1-year.The two groups were compared by SPSS 22.0 statistical software package. Compared the 1-year DFS between the two groups, and analysed the clinical data which affect the TACE group 1-year DFS by Kaplan-Meier analysis. COX's regression model of multivariate analysis was done in order to figure out the independent risk factors which had influenced the outcome after preventive TACE in patients with hepatocellular carcinoma and MVI underwent radical hepatectomy of hepatocellular carcinoma. Results:There was no significant of the baseline data of two groups. The DFS of 42 Patients who received preventive TACE was 61.4%(26/42), The DFS of 32 Patients who wthout preventive TACE was 31.5%(12 / 32), and there was significant difference in the 1-year DFS between the two group(P=0.039). The risk factors of the TACE group were AFP(P=0.030), tumor capsule(P=0.035), liver cirrhosis(P=0.037),by Kaplan-Meier analysis. Cox multivariate analysis showed that tumor capsule(P=0.035), liver cirrhosis(P=0.037) were the independent risk factors for the TACE group. Conclusion:1. Preventive TACE can reduce the early recurrence rate within 1-year of small Hepatocellular carcinoma with MVI.2. Tumour capsule whether complete and whether or not combined liver cirrhosis were independent risk factors for the prognositic of patients with MVI small hepatocellular carcinoma after preventive TACE treatment.