Objective: To explore the effect of postoperative adjuvant transarterial chemoembolization (TACE) upon early recurrence of hepatocellular carcinoma (HCC) patients after radical resection.
Methods: Between November 2000 and December 2007, 2591 HCC patients undergoing radical resection were retrospectively recruited. Patients undergoing resection alone were selected as control group while those receiving post-operative adjuvant TACE as intervention group. The patients were further stratified into tumor < or = 5 cm with low or high risk factors for residual tumor and tumor > 5 cm with low or high risk factors for residual tumor. A low risk factor for residual tumor was defined as single tumor and without microscopic tumor thrombus while a high risk factor for residual tumor was defined as 2 - 3 nodules or with the presence of microscopic tumor thrombus. The effect of adjuvant TACE upon early (< or = 2 years) recurrence was evaluated.
Results: Recurrent rates of tumor < or = 5 cm with low or high risk factors for residual tumor and tumor > 5 cm with low or high risk factors for residual tumor at Month 3 post-resection were 1.34%, 3.17%, 5.33% and 8.43% in the control group versus 4.14% (P = 0.002), 8.15% (P = 0.011), 12.88% (P = 0.002) and 14.29% (P = 0.045) respectively in the intervention group; recurrence rates at Month 6 post-resection were 4.63%, 8.73%, 11.50% and 19.46% in the control group versus 6.71% (P = 0.133), 13.48% (P = 0.070), 21.02% (P = 0.052) and 23.94% (P = 0.210) respectively in the intervention group. For patients remaining recurrence free within the first 6 months post-resection, there were no significant differences in recurrence rates at Months 9, 12, 18 and 24 post-operation between each intervention group and control group.
Conclusion: Postoperative adjuvant TACE has no preventive effect upon early recurrence, but may be of benefit to detect residual tumor and early recurrence.
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