AIM:To compare survival and recurrence in hepatocellular carcinoma(HCC)patients who did or did not receive adjuvant transarterial chemoembolization(TACE).METHODS:A consecutive sample of 229 patients who underwent cura...AIM:To compare survival and recurrence in hepatocellular carcinoma(HCC)patients who did or did not receive adjuvant transarterial chemoembolization(TACE).METHODS:A consecutive sample of 229 patients who underwent curative resection between March 2007 and March 2010 in our hospital was included.Of these 229 patients,91(39.7%)underwent curative resection followed by adjuvant TACE and 138(60.3%)underwent curative resection alone.In order to minimize confounds due to baseline differences between the two patient groups,comparisons were conducted between propensity score-matched patients.Survival data and recurrence rates were compared using the Kaplan-Meier method.Independent predictors of overall survival and recurrence were identified using Cox proportional hazard regression.RESULTS:Among 61 pairs of propensity scorematched patients,the 1-,2-,and 3-year overall survival rates were 95.1%,86.7%,and 76.4%in the TACE group and 86.9%,78.5%,and 73.2%in the control group,respectively.At the same time,the TACE and control groups also showed similar recurrence rates at 1 year(13.4%vs 24.8%),2 years(30.6%vs 32.1%),and 3 years(40.1%vs 34.0%).Multivariate Cox regression identified serum alpha-fetoprotein level≥400 ng/mL and tumor size>5 cm as independent risk factors of mortality(P<0.05).CONCLUSION:As postoperative adjuvant TACE does not improve overall survival or reduce recurrence in HCC patients,further study is needed to clarify its clinical benefit.展开更多
基金Supported by National Natural Science Foundation of China,No.81260331 and No.81360312the Graduate Innovational Foundation of Guangxi,No.YCSZ2014108the National Science and Technology Major Project of the Ministry of Science and Technology of China,No.2012ZX10002010001009.
文摘AIM:To compare survival and recurrence in hepatocellular carcinoma(HCC)patients who did or did not receive adjuvant transarterial chemoembolization(TACE).METHODS:A consecutive sample of 229 patients who underwent curative resection between March 2007 and March 2010 in our hospital was included.Of these 229 patients,91(39.7%)underwent curative resection followed by adjuvant TACE and 138(60.3%)underwent curative resection alone.In order to minimize confounds due to baseline differences between the two patient groups,comparisons were conducted between propensity score-matched patients.Survival data and recurrence rates were compared using the Kaplan-Meier method.Independent predictors of overall survival and recurrence were identified using Cox proportional hazard regression.RESULTS:Among 61 pairs of propensity scorematched patients,the 1-,2-,and 3-year overall survival rates were 95.1%,86.7%,and 76.4%in the TACE group and 86.9%,78.5%,and 73.2%in the control group,respectively.At the same time,the TACE and control groups also showed similar recurrence rates at 1 year(13.4%vs 24.8%),2 years(30.6%vs 32.1%),and 3 years(40.1%vs 34.0%).Multivariate Cox regression identified serum alpha-fetoprotein level≥400 ng/mL and tumor size>5 cm as independent risk factors of mortality(P<0.05).CONCLUSION:As postoperative adjuvant TACE does not improve overall survival or reduce recurrence in HCC patients,further study is needed to clarify its clinical benefit.
