OBJECTIVE: To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable large hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: Resection of HCC is potentially curative, but local recurrence is very common. There is currently no effective neoadjuvant or adjuvant therapy. METHODS:From July 2001 to December 2003, 108 patients (hepatitis B carrier = 98.1%) with resectable HCC (> or =5 cm) was randomly assigned to preoperative TACE treatment (n = 52) or no preoperative treatment (control group) (n = 56). RESULTS: Five patients (9.6%) in the preoperative TACE group did not receive surgical therapy because of extrahepatic metastasis or liver failure. The preoperative TACE group had a lower resection rate (n = 47, 90.4% vs. n = 56, 100%; P= 0.017), and longer operative time (mean, 176.5 minutes vs. 149.3 minutes; P= 0.042). No significant difference was found between the 2 groups in operative blood loss, surgical morbidity, and hospital mortality.At a median follow-up of 57 months, 41 (78.8%) of 52 patients in the preoperative TACE group and 51 (91.1%) of 56 patients in the control group had recurrent disease (P= 0.087). The 1-, 3-, and 5-year disease-free survival rates were 48.9%, 25.5%, and 12.8%, respectively, for the preoperative TACE group and 39.2%, 21.4%, and 8.9%, respectively, for the control group (P= 0.372). The 1-, 3-, and 5-year overall survival rates were 73.1%, 40.4%, and 30.7%, respectively, for the preoperative TACE group and 69.6%, 32.1%, and 21.1%, respectively, for the control group (P= 0.679). CONCLUSIONS: Preoperative TACE did not improve surgical outcome. It resulted in drop-out from definitive surgery because of progression of disease and liver failure.
RCT Entities:
OBJECTIVE: To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable large hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: Resection of HCC is potentially curative, but local recurrence is very common. There is currently no effective neoadjuvant or adjuvant therapy. METHODS: From July 2001 to December 2003, 108 patients (hepatitis B carrier = 98.1%) with resectable HCC (> or =5 cm) was randomly assigned to preoperative TACE treatment (n = 52) or no preoperative treatment (control group) (n = 56). RESULTS: Five patients (9.6%) in the preoperative TACE group did not receive surgical therapy because of extrahepatic metastasis or liver failure. The preoperative TACE group had a lower resection rate (n = 47, 90.4% vs. n = 56, 100%; P= 0.017), and longer operative time (mean, 176.5 minutes vs. 149.3 minutes; P= 0.042). No significant difference was found between the 2 groups in operative blood loss, surgical morbidity, and hospital mortality.At a median follow-up of 57 months, 41 (78.8%) of 52 patients in the preoperative TACE group and 51 (91.1%) of 56 patients in the control group had recurrent disease (P= 0.087). The 1-, 3-, and 5-year disease-free survival rates were 48.9%, 25.5%, and 12.8%, respectively, for the preoperative TACE group and 39.2%, 21.4%, and 8.9%, respectively, for the control group (P= 0.372). The 1-, 3-, and 5-year overall survival rates were 73.1%, 40.4%, and 30.7%, respectively, for the preoperative TACE group and 69.6%, 32.1%, and 21.1%, respectively, for the control group (P= 0.679). CONCLUSIONS: Preoperative TACE did not improve surgical outcome. It resulted in drop-out from definitive surgery because of progression of disease and liver failure.
Authors: Markus Peck-Radosavljevic; Wolfgang Sieghart; Claus Kölblinger; Markus Reiter; Martin Schindl; Gregor Ulbrich; Rudolf Steininger; Christian Müller; Rudolf Stauber; Maximilian Schöniger-Hekele; Manfred Gschwendtner; Christina Plank; Martin Funovics; Ivo Graziadei; Johannes Lammer; Thomas Gruenberger; Günther Gastl; Franz Karnel Journal: Wien Klin Wochenschr Date: 2011-09-22 Impact factor: 1.704
Authors: M Sherman; K Burak; J Maroun; P Metrakos; J J Knox; R P Myers; M Guindi; G Porter; J R Kachura; P Rasuli; S Gill; P Ghali; P Chaudhury; J Siddiqui; D Valenti; A Weiss; R Wong Journal: Curr Oncol Date: 2011-10 Impact factor: 3.677
Authors: Victor M Zaydfudim; Neeta Vachharajani; Goran B Klintmalm; William R Jarnagin; Alan W Hemming; Maria B Majella Doyle; Keith M Cavaness; William C Chapman; David M Nagorney Journal: Ann Surg Date: 2016-10 Impact factor: 12.969