Objective: To evaluate the effect of postoperative TACE for prevention and treatment of hepatocellular carcinoma (HCC) recurrence after radical resection.
Methods: From Jan. 1995 through March 1998, 109 HCC patients after radical resection were followed up with serum AFP, liver US and CT, chest X-ray film, hepatic artery angiography, etc. They were divided into 2 groups. Patients in group A (n = 68) with no residual tumor were given prophylactic TACE treatment, 1-2 times at the second and fifth month after operation. Patients in group B (n = 41) with residual tumor left were treated with regular TACE, once every 2 months. The 2 groups of patients were followed up for 6-45 months after operation.
Results: In group A, the real curative resection rate was 62.4%. Tumor recurrence was found in 10 of the 68 patients, with a total recurrence rate of 14.7% within 3 years after radical resection. The 1-, 2-, and 3-year cumulative recurrence rate was 7.4%, 13.2% and 14.7%, respectively. The 1-, 2-, and 3-year survival rate was 100%, 93.4% and 85.7%, respectively, while that in group B was 78.1%, 57.7% and 57.7%, respectively. The differences between the 2 groups of patients were statistically significant. The predictive pathological factors hampering completeness of tumor resection were: tumor size > 5 cm, more than 2 tumor nodules, the presence of satellite nodules, tumor with partial or without encapsulation and tumor thrombus in portal vein. Hepatic artery angiography with LP-CT and maintenance of high serum AFP level were the most sensitive methods for detecting residual tumor after operation.
Conclusion: Post-operative TACE is very useful for prevention and treatment of HCC recurrence. It helps improve survival of surgically treated HCC patients.