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Efficacy and Safety of Transarterial Chemoembolization in Recurrent Hepatocellular Carcinoma After Curative Surgical Resection

Choi, Jong Won MD*†; Park, Jun Yong MD*†‡; Ahn, Sang Hoon MD*†‡; Yoon, Ki Tae MD*†; Ko, Heung-kyu MD§; Lee, Do Yun MD§; Lee, Jong Tae MD§; Kim, Kyung Sik MD¶; Choi, Jin Sub MD¶; Han, Kwang-Hyub MD*†‡; Chon, Chae Yoon MD*†‡; Kim, Do Young MD*†‡

American Journal of Clinical Oncology: December 2009 - Volume 32 - Issue 6 - pp 564-569
doi: 10.1097/COC.0b013e3181967da0
Original Article: Gastointestinal

Objectives: To evaluate the efficacy and safety of transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after curative resection and to examine the factors associated with the prognosis in a single center.

Methods: Between January 1995 and July 2006, 169 patients who had undergone curative resection were diagnosed with recurrent HCC. Of these, 114 patients underwent TACE as first-line therapy and were followed until July 2007.

Results: At the time of resection, the mean tumor size was 4.8 ± 2.9 cm, and 96 (84.2%) patients had a single tumor. Single nodular recurrence was observed in 53 (46.5%) patients. The mean size of the recurrent HCC was 2.1 ±1.2 cm. The disease-free survival after TACE was 46.0%, 16.7%, and 13.4% at 1, 2, and 3 years, respectively. The overall survival after TACE was 77.8%, 53.6%, and 31.6% at 1, 3, and 5 years, respectively. Cox regression analysis revealed that the Edmonson grade and time to recurrence (>6 months) independently affected the disease-free survival (both P < 0.05). The time to recurrence (>6 months) and tumor-node-metastasis stage were associated with overall survival (both P < 0.05). Only 1 lethal complication (biliary sepsis) occurred after TACE.

Conclusions: TACE seems to be a safe, effective treatment for recurrent HCC after curative resection.

From the *Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; †Liver Cirrhosis Clinical Research Center, Seoul, Korea; ‡Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea; and Departments of §Interventional Radiology and ¶Surgery, Yonsei University College of Medicine, Seoul, Korea.

Supported by a grant (A050021) from the Korea Health 21 R and D project from the Ministry of Health and Welfare, Republic of Korea.

Reprints: Do Young Kim, MD, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, South Korea. E-mail: dyk1025@yuhs.ac.

© 2009 Lippincott Williams & Wilkins, Inc.