| Objective:Hepatectomy is one of the radical methods for Hepatocellular carcinoma(HCC),but the recurrence rate of 5 years after operation is as high as 50-70%,affecting its therapeutic effect.Studies have confirmed that microvascular invasion(MVI)is one of the risk factors for postoperative recurrence of Hepatocellular carcinoma.Postoperative preventive treatment for Hepatocellular carcinoma patients with microvascular invasion will reduce the postoperative recurrence rate of liver cancer.In this study,the clinical data of 169 patients with hepatocellular carcinoma with microvascular invasion were statistically analyzed and followed up.The aim is to investigate the influence of adjuvant Transcatheter Arterial Chemoembolization(TACE)with anti-tumor drug on early recurrence of Hepatocellular carcinoma patients with Microvascular invasion after radical hepatectomy.Methods:The study was analyzed with cohort study method.The clinical and pathological data of 169 patients with hepatocellular carcinoma who underwent radical hepatectomy from January 2015 to December 2018 in Affiliated Hospital of Qingdao University were retrospectively analyzed.Clinical data of liver cancer patients with MVI were diagnosed by postoperative pathology.The following data were collected:general clinical data(sex,age,past history,personal history),preoperative laboratory data(related indexes of liver function,related tumor markers),surgical data(duration of operation,intraoperative blood loss,hilar occlusion time)and pathological data(maximum diameter of tumor,number of tumors,Edmonson grade,integrity of capsule,cirrhosis and satellite nodules).The patients were divided into group A(patients who did not accept adjuvant therapy),group B(patients who only accept TACE)and group C(patients who accept TACE with anti-tumor drug group),according to the methods of different therapy after resection.All patients were followed up at least 24 months.Tumor recurrence was compared among the three groups.The relapse-free survival times among the three groups were compared by the Kaplan-Meier method.Independent predictors of recurrence were identified with Cox proportional hazard regression,and log-rank test was used to compare the tumor-free survival rate.Results:This study included 660 hepatocellular carcinoma patients with MVI who underwent radical hepatectomy from January 2015 to December 2017 in the Affiliated Hospital of Qingdao University.All patients were followed up.There were 147 males and22 females,accounting for 87%of males;the average age was 56 years(range 32-79 years).The postoperative 1,2-year overall recurrence rates of liver cancer were 40.8%(69/169)and 59.2%(100/169).And 1,2-year month overall recurrence rates of liver cancer were54.8%(34/62)and 74.2%(46/62)in the group A,38.1%(16/42)and 57.1%(24/42),in the group B and 29.25%(19/65)and 46.2%(30/65)in the group C,respectively,showing significant differences between the 3 groups(x~2=11.816,P=0.003;x~2=15.278,P=0.000).The univariate analysis showed that postoperative adjuvant treatment,Edmonson pathological grade III/IV grade,number of tumors,diameter of maximal tumor and satellite lesion were risk factors for early recurrence after radical resection of hepatocellular carcinoma with MVI(x~2=9.180、5.100、4.613、5.678、8.732、4.610、10.012,P<0.05).The results of multivariate Cox proportional-hazards regression model showed that postoperative adjuvant TACE,postoperative adjuvant TACE with antineoplastic drugs,Edmonson pathological grade,number of tumors,diameter of maximal tumor and satellite lesion were independent risk factors for early recurrence after radical resection of hepatocellular carcinoma with MVI(P<0.05).Patients in group C who received different antineoplastic drugs were divided into two groups.There were 65 patients in group C,including 48 patients who received general antineoplastic drugs and 17 patients who received targeted drugs.The 2-year disease-free survival rate of the general antineoplastic drug group was 50.0%,and the two-year disease-free survival rate of the targeted drug group was 64.7%.There was no significant difference between the two groups(x~2=0.688,P=0.407).Conclusion:Adjuvant TACE can reduce the early recurrence rate of Hepatocellular carcinoma with MVI.Adjuvant TACE with anti-tumor drug significantly reduced tumor early recurrence. |
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