Chao Li1, Ming-Da Wang1, Lun Lu2, Han Wu1, Jiong-Jie Yu1, Wan-Guang Zhang3, Timothy M Pawlik4, Yao-Ming Zhang5, Ya-Hao Zhou6, Wei-Min Gu7, Hong Wang8, Ting-Hao Chen9, Jun Han1, Hao Xing1, Zhen-Li Li1, Wan Yee Lau1,10, Meng-Chao Wu1, Feng Shen11, Tian Yang12. 1. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), No. 225, Changhai Road, Shanghai, 200438, China. 2. Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China. 3. Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China. 4. Department of Surgery, Wexner Medical Center, Ohio State University, Columbus, OH, USA. 5. The 2nd Department of Hepatobiliary Surgery, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital to Sun Yat-sen University, Meizhou, China. 6. Department of Hepatobiliary Surgery, Pu'er People's Hospital, Yunnan, China. 7. The 1st Department of General Surgery, The Fourth Hospital of Harbin, Heilongjiang, China. 8. Department of General Surgery, Liuyang People's Hospital, Hunan, China. 9. Department of General Surgery, Ziyang First People's Hospital, Sichuan, China. 10. Faculty of Medicine the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T.,, Hong Kong, SAR, China. 11. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), No. 225, Changhai Road, Shanghai, 200438, China. fengshensmmu@gmail.com. 12. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), No. 225, Changhai Road, Shanghai, 200438, China. yangtianehbh@smmu.edu.cn.
Abstract
BACKGROUND AND AIMS: Surgical resection for hepatocellular carcinoma (HCC) is potentially curative, but long-term survival remains unsatisfactory. There is currently no effective neoadjuvant or adjuvant therapy for HCC. We sought to evaluate the impact of preoperative transcatheter arterial chemoembolization (TACE) on long-term prognosis after surgical resection of huge HCCs (≥ 10 cm). METHODS: Using a multicenter database, consecutive patients who underwent curative-intent resection for huge HCC without macrovascular invasion between 2004 and 2014 were identified. The association between preoperative TACE with perioperative outcomes, long-term overall survival (OS), and recurrence-free survival (RFS) was assessed before and after propensity score matching (PSM). RESULTS: Among the 377 enrolled patients, 88 patients (23.3%) received preoperative TACE. The incidence of perioperative mortality and morbidity was comparable among patients who did and did not undergo preoperative TACE (3.4% vs. 2.4%, p= 0.704, and 33.0% vs. 31.1%, p= 0.749, respectively). PSM analysis created 84 matched pairs of patients. In examining the entire cohort as well as the PSM cohort, median OS (overall cohort: 32.8 vs. 22.3 months, p= 0.035, and PSM only: 32.8 vs. 18.1 months, p= 0.023, respectively) and RFS (12.9 vs. 6.4 months, p= 0.016, and 12.9 vs. 4.1 months, p= 0.009, respectively) were better among patients who underwent preoperative TACE vs. patients who did not. After adjustment for other confounding factors on multivariable analyses, preoperative TACE remained independently associated with a favorable OS and RFS after the resection of huge HCC. CONCLUSION: Preoperative TACE did not increase perioperative morbidity or mortality, yet was associated with an improved OS and RFS after liver resection of huge HCC (≥ 10 cm).
BACKGROUND AND AIMS: Surgical resection for hepatocellular carcinoma (HCC) is potentially curative, but long-term survival remains unsatisfactory. There is currently no effective neoadjuvant or adjuvant therapy for HCC. We sought to evaluate the impact of preoperative transcatheter arterial chemoembolization (TACE) on long-term prognosis after surgical resection of huge HCCs (≥ 10 cm). METHODS: Using a multicenter database, consecutive patients who underwent curative-intent resection for huge HCC without macrovascular invasion between 2004 and 2014 were identified. The association between preoperative TACE with perioperative outcomes, long-term overall survival (OS), and recurrence-free survival (RFS) was assessed before and after propensity score matching (PSM). RESULTS: Among the 377 enrolled patients, 88 patients (23.3%) received preoperative TACE. The incidence of perioperative mortality and morbidity was comparable among patients who did and did not undergo preoperative TACE (3.4% vs. 2.4%, p= 0.704, and 33.0% vs. 31.1%, p= 0.749, respectively). PSM analysis created 84 matched pairs of patients. In examining the entire cohort as well as the PSM cohort, median OS (overall cohort: 32.8 vs. 22.3 months, p= 0.035, and PSM only: 32.8 vs. 18.1 months, p= 0.023, respectively) and RFS (12.9 vs. 6.4 months, p= 0.016, and 12.9 vs. 4.1 months, p= 0.009, respectively) were better among patients who underwent preoperative TACE vs. patients who did not. After adjustment for other confounding factors on multivariable analyses, preoperative TACE remained independently associated with a favorable OS and RFS after the resection of huge HCC. CONCLUSION: Preoperative TACE did not increase perioperative morbidity or mortality, yet was associated with an improved OS and RFS after liver resection of huge HCC (≥ 10 cm).
Authors: G E Gerunda; D Neri; R Merenda; F Barbazza; F Zangrandi; F Meduri; M Bisello; M Valmasoni; A Gangemi; A M Faccioli Journal: Liver Transpl Date: 2000-09 Impact factor: 5.799
Authors: Tushar Garg; Apurva Shrigiriwar; Peiman Habibollahi; Mircea Cristescu; Robert P Liddell; Julius Chapiro; Peter Inglis; Juan C Camacho; Nariman Nezami Journal: Cancers (Basel) Date: 2022-07-10 Impact factor: 6.575