Annals of Surgical Oncology

, Volume 17, Issue 3, pp 869–877

Complete Necrosis After Transarterial Chemoembolization Could Predict Prolonged Survival in Patients with Recurrent Intrahepatic Hepatocellular Carcinoma After Curative Resection

  • Ju Hyun Shim
  • Kang Mo Kim
  • Young-Joo Lee
  • Gi-Young Ko
  • Hyun-Ki Yoon
  • Kyu-Bo Sung
  • Kwang-Min Park
  • Sung-Gyu Lee
  • Young-Suk Lim
  • Han Chu Lee
  • Young-Hwa Chung
  • Yung Sang Lee
  • Dong Jin Suh
Hepatobiliary Tumors

DOI: 10.1245/s10434-009-0788-7

Cite this article as:
Shim, J.H., Kim, K.M., Lee, YJ. et al. Ann Surg Oncol (2010) 17: 869. doi:10.1245/s10434-009-0788-7

Abstract

Background

We explored the predictors of response to transarterial chemoembolization (TACE) in patients with recurrent intrahepatic hepatocellular carcinoma (HCC) after hepatectomy and investigated the survival of these patients according to the response to TACE.

Methods

We analyzed data from 199 consecutive HCC patients who underwent curative liver resection and who later received repeat TACE for intrahepatic HCC recurrence.

Results

Of 199 patients, 139 (69.8%) achieved complete necrosis (CN) of HCC after repeated TACE (mean TACE session number, 1.3) and the other 60 (30.2%) (non-CN group) did not achieve CN. At hepatectomy, the CN group showed significantly smaller proportions of tumor capsular invasion, microvascular invasion, and pathologic tumor–node–metastasis stage III or IV HCCs. At first TACE, the CN group showed a significantly greater proportion of patients with time to recurrence ≥ 1 year, Child–Pugh class A, serum alpha-fetoprotein (AFP) levels < 200 ng/mL, tumor size < 3 cm, solitary tumors, and nodular tumor types; portal vein invasion were less common than seen in the non-CN group. After multivariate analysis, tumor size < 3 cm and a single tumor at first TACE were independently related to attainment of CN after TACE. Median survival after first TACE was significantly longer in the CN group (48.9 versus 17.0 months). In a Cox regression model, CN after TACE was an independent predictor of favorable survival outcome after first TACE.

Conclusions

CN after repeat TACE for postresection intrahepatic recurrence was attained more commonly in patients with smaller tumor size and lower tumor number at first TACE and favored longer survival in recurrent patients.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Ju Hyun Shim
    • 1
  • Kang Mo Kim
    • 1
  • Young-Joo Lee
    • 2
  • Gi-Young Ko
    • 3
  • Hyun-Ki Yoon
    • 3
  • Kyu-Bo Sung
    • 3
  • Kwang-Min Park
    • 2
  • Sung-Gyu Lee
    • 2
  • Young-Suk Lim
    • 1
  • Han Chu Lee
    • 1
  • Young-Hwa Chung
    • 1
  • Yung Sang Lee
    • 1
  • Dong Jin Suh
    • 1
  1. 1.Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  3. 3.Department of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea