World Journal of Surgery

, Volume 37, Issue 5, pp 1034–1042 | Cite as

Adjuvant Hepatic Arterial Infusion Chemotherapy after Hepatic Resection of Hepatocellular Carcinoma With Macroscopic Vascular Invasion

  • Hidetoshi Nitta
  • Toru Beppu
  • Katsunori Imai
  • Hiromitsu Hayashi
  • Akira Chikamoto
  • Hideo Baba



The prognosis of hepatocellular carcinoma (HCC) with macroscopic vascular invasion is extremely poor even after hepatic resection. We aimed to clarify the efficacy of adjuvant hepatic arterial infusion chemotherapy (HAI) for HCC with vascular invasion.


A total of 73 HCC patients with macroscopic vascular invasion were divided into two groups: 38 with hepatectomy with HAI (HAI group) and 35 with hepatectomy alone (non-HAI group). From 1997 to 2007, HAI was performed via an implanted injection port. The treatment comprised three courses of weekly infusion of HAI, which comprised cisplatin (10 mg daily on days 1–5) followed by 5-fluorouracil (5-FU; 250 mg daily on days 1–5) infusion. From 2007, cisplatin (60 mg/m2), 5-FU (600 mg/m2), and a mixture of mitomycin C (3 mg/m2) and degradable starch microspheres were administered for two courses.


Overall, 92 % of patients completed adjuvant HAI. In the HAI and non-HAI groups, the 5-year disease-free survival (DFS) rates were 33.1 % and 11.8 %, respectively (p = 0.029), and the 5-year overall survival (OS) rates were 46.7 % and 32.7 %, respectively (p = 0.318). Among the patients with Vp3/4 or Vv3 (n = 32) in the HAI group, the 3-year DFS and OS rates were 33.7 % and 56.8 %, respectively (p = 0.049). Those in the non-HAI group were 8.3 % and 12.0 %, respectively (p = 0.023). Cox proportional multivariate analysis for DFS revealed that HAI was an independent favorable prognostic factor in all 73 patients (hazard ratio 0.536; p = 0.029).


Adjuvant HAI for HCC patients with vascular invasion might reduce the risk of recurrence.


Overall Survival Tace Hepatic Resection Hepatic Arterial Infusion Portal Vein Tumor Thrombosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare no conflicts of interest.


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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Hidetoshi Nitta
    • 1
  • Toru Beppu
    • 1
    • 2
  • Katsunori Imai
    • 1
  • Hiromitsu Hayashi
    • 1
  • Akira Chikamoto
    • 1
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Medical School HospitalKumamoto UniversityKumamotoJapan
  2. 2.Department of Multidisciplinary Treatment for Gastroenterological Cancer, Innovation Center for Translational Research, Kumamoto University HospitalKumamotoJapan

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