Clinical value of prophylactic transcatheter arterial chemoembolization treatment in patients with hepatocellular carcinoma

Am J Transl Res. 2022 May 15;14(5):3225-3232. eCollection 2022.

Abstract

Objective: To investigate the feasibility of surgical resection combined with prophylactic transcatheter arterial chemoembolization (TACE) in reducing the recurrence and improving the survival rate of patients with hepatocellular carcinoma (HCC).

Methods: In this retrospective study, 76 patients with HCC treated in our hospital from February 2016 to December 2018 were enrolled. Among them, 31 patients who received radical surgery alone were enrolled as the control group, and 45 patients who received prophylactic TACE within 6 months after radical surgery were enrolled as the study group. All cases were followed up for 36 months. The recurrence rate, survival rate, and median survival time of patients at 1, 2, and 3 years after surgery were compared between the two groups. Patients in the study group were divided into subgroup A (interventional therapy within 1 month), subgroup B (interventional therapy within 1-2 months), subgroup C (interventional therapy within 2-3 months), and subgroup D (interventional therapy within 3-6 months). The recurrence rate within 1 year was compared among the four subgroups. Finally, the clinical indicators affecting the recurrence of HCC were analyzed.

Results: The recurrence rate at 1, 2 and 3 years after surgery in the study group was lower than that in the control group (all P<0.05). The survival rate at 1, 2 and 3 years after surgery in the study group was higher than that in the control group (all P<0.05). The median survival time of patients in the study group was slightly higher than that in the control group, with no significant difference (P>0.05). The 1-year recurrence rate of patients in subgroups A and B was significantly lower than that in subgroups C and D (P<0.05). The incomplete envelope, tumor diameter ≥5 cm, and combined cirrhosis were the main causes of recurrence of HCC (P<0.05).

Conclusion: Prophylactic TACE significantly reduced the postoperative recurrence rate and improved the survival rate of patients with HCC. The optimal treatment efficacy was associated with interventional therapy within 1-2 months after surgery, while incomplete envelope, tumor diameter ≥5 cm, and combined cirrhosis were the high-risk factors for HCC recurrence.

Keywords: Surgical resection; hepatocellular carcinoma; interventional therapy; recurrence rate; survival rate.