Transarterial chemoembolization versus surgery/radiofrequency ablation for recurrent hepatocellular carcinoma with or without microvascular invasion. Issue 5 (May 2014)

• Record Type: Journal Article
• Authors: Jin, Young‐Joo; Lee, Jin‐Woo; Lee, Oh Hyun; Chung, Hyun Jung; Kim, Young Soo; Lee, Jung Il; Cho, Soon Gu; Jeon, Yong Sun; Lee, Kun Young; Ahn, Seung‐Ik; Shin, Woo Young
• Is Part Of: Journal of gastroenterology and hepatology. Volume 29:Issue 5(2014:May)
• Page Start: 1056
• Page End: 1064
• Publication Date: 2014-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12507
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12507-sec-0001" sec-type="section"> <title>Background/Aims</title> <p>Microvascular invasion (MVI) is a well‐known prognostic factor of postoperative recurrence and of overall survival (OS) in patients with hepatocellular carcinoma (HCC). We compared the treatment outcomes of transarterial chemoembolization (TACE) and surgery/radiofrequency ablation (RFA) according to the presence of MVI in patients with early or late recurrent HCC that presented as Barcelona Clinical Liver Cancer (BCLC) stage 0 or A after curative resection for HCC.</p> </sec> <sec id="jgh12507-sec-0002" sec-type="section"> <title>Methods</title> <p>A consecutive 68 patients with recurrent HCC of BCLC stage 0 or A at our institution between 1998 and 2012 were retrospectively enrolled. We compared the outcomes of patients treated by TACE or surgery/RFA. Tumor recurrence after curative resection was classified as early (≤ 12 months) or late (> 12 months) recurrence.</p> </sec> <sec id="jgh12507-sec-0003" sec-type="section"> <title>Results</title> <p>Median tumor size was 1.5 cm (range, 1–10 cm), and 67 (98.5%) had HCCs within the Milan criteria. Median post‐retreatment follow‐up duration was 27 months (range, 1–109 months). Of the 68 patients, 19 (27.9%) underwent surgery/RFA, 47 (69.1%) TACE, and 2 (2.9%) were lost to follow‐up. After retreatment, TACE showed significantly higher OS and recurrence‐free survival rates than surgery/RFA in MVI‐positive patients (<italic>P</italic> = 0.03 and <italic>P</italic> = 0.05, respectively), but not in MVI‐negative patients (<italic>P</italic> = 0.95 and <italic>P</italic> = 0.98, respectively). In particular, in early recurred MVI‐positive patients, TACE had a significantly higher OS rate than surgery/RFA (<italic>P</italic> = 0.01).</p> </sec> <sec id="jgh12507-sec-0004" sec-type="section"> <title>Conclusions</title> <p>TACE may be the more effective treatment option for recurrent HCC of BCLC stage 0 or A than surgery/RFA in MVI‐positive patients, especially in those that recur early after curative resection.</p> </sec> </abstract>