Adjuvant transarterial chemoembolization for patients with hepatocellular carcinoma involving microvascular invasion

• Published in: The American journal of surgery Vol. 217; no. 4; pp. 739 - 744
• Main Authors: Qi, Ya-Peng, Zhong, Jian-Hong, Liang, Zhi-Yin, Zhang, Jie, Chen, Bin, Chen, Chang-Zhi, Li, Le-Qun, Xiang, Bang-De
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2019; Elsevier Limited
• Subjects: Adjuvant; Age; Aged; Antineoplastic Agents - therapeutic use; Blood platelets; Cancer therapies; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Chemoembolization, Therapeutic - methods; Chemotherapy, Adjuvant; Female; Gender; Hepatic resection; Hepatitis; Hepatocellular carcinoma; Hospitals; Humans; Liver cancer; Liver cirrhosis; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Medical imaging; Medical prognosis; Metastasis; Microvascular invasion; Microvasculature; Middle Aged; Neoplasm Invasiveness - pathology; NMR; Nuclear magnetic resonance; Patients; Prognosis; Prospective Studies; Subgroups; Survival; Survival analysis; Survival Rate; Transarterial chemoembolization; Tumors; Variables; Vascular Neoplasms - pathology; China; Hepatocellular carcinoma; Adjuvant; Microvascular invasion; Transarterial chemoembolization; Hepatic resection
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.07.054

Microvascular invasion (MVI) has recently been reported to be an independent prognostic factor in patients with hepatocellular carcinoma (HCC). This study compared the outcomes of adjuvant transarterial chemoembolization (A-TACE) after hepatic resection (HR) in patients with HCC involving MVI. This prospective study involved 200 consecutive patients with MVI-HCC who underwent HR alone (n = 109) or HR with A-TACE (n = 91).The Kaplan-Meier method was used to compare disease-free survival (DFS) and overall survival (OS). The two groups showed similar DFS at 1, 2, and 3 years (P = 0.077). The A-TACE group showed significantly higher OS than the HR-only group (P = 0.030). Subgroup analysis showed that A-TACE was associated with significantly higher DFS and OS among patients with a tumor diameter >5 cm or with multinodular tumors. A-TACE may improve postoperative outcomes for MVI-HCC patients, especially those with tumor diameter >5 cm or multinodular tumors. •Microvascular invasion (MVI) has been reported to be an independent prognostic factor in HCC patients.•Our study suggest that adjuvant transarterial chemoembolization (A-TACE) may improve postoperative overall survival (OS), but without improving disease-free survival (DFS).•Further, our data fond that the survival benefit of A-TACE was particularly evident among MVI-HCC patients with recurrence risk factors, such as tumor diameter >5 cm and multinodular disease.