[Exploration of indication of prophylactic transcatheter arterial chemoembolization on postoperative recurrence of hepatocellular carcinoma].

OBJECTIVE: To evaluate the efficacy of prophylactic transcatheter arterial chemoembolization (TACE) on postoperative recurrence of hepatocellular carcinoma. METHODS: A retrospective analysis was performed on clinicopathologic data of 260 hepatocellular carcinoma patients who underwent curative hepatectomy in Eastern Hepatobiliary Surgery Hospital, Second Military Medical University from January 2004 to June 2007. Among the 260 patients, 104 underwent postoperative prophylactic TACE and the other 156 were not. RESULTS: The overall survival rates at 1- and 2-years were 84.1% and 70.5% respectively. The overall disease-free survival rates at 1- and 2-years were 69.2% and 58.4% respectively. Of 260 overall patients, the disease-free survival rates at 1- and 2-years were 72.8% and 54.9% respectively in TACE group, and 66.9% and 59.7% respectively in non-TACE group, statistically significant difference of the cumulative disease-free survival rates at 1- and 2-years between TACE group and non-TACE group were not observed (P = 0.145, P = 0.405). Of 62 patients with tumor size >or= 10 cm, the disease-free survival rates at 1- and 2-years were respectively 66.6% and 48.7% in TACE group, and respectively 44.6% and 31.2% years between TACE group and non-TACE group were observed (P = 0.025, P = 0.025). Of 38 patients with vascular tumor thrombi, the disease-free survival rates at 1- and 2-years were respectively 33.0% and 0 in TACE group, and respectively 26.2% and 21.8% in non-TACE group, statistically significant difference of the cumulative disease-free survival rates at 1-years between TACE group and non-TACE group was observed (P = 0.025), and not at 2-years (P = 0.122). CONCLUSIONS: In non-TACE group, statistically significant difference of the cumulative disease-free survival rates at 1- and 2-Prophylactic TACE is preferred for hepatocellular carcinoma patients with high risk factors for recurrence such as tumor size >or= 10 cm and presented vascular tumor thrombi.