Scholarlink

Background <p>The efficacy of preoperative transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) remains unclear. This study aimed to investigate the impact of preoperative TACE for resectable solitary HCC.</p> Methods <p>This retrospective study included 4899 patients who underwent hepatectomy from 2008 to 2019. Survival outcomes were compared before and after propensity score matching (PSM) based on tumor size (≤&#xa0;3, 3–5, and &gt;&#xa0;5&#xa0;cm) between the preoperative TACE (<i>n</i>&#xa0;=&#xa0;378) and upfront surgery groups (<i>n</i>&#xa0;=&#xa0;4521). Cox regression analysis was utilized to identify predictors of overall survival (OS) and recurrence-free survival (RFS).</p> Results <p>For HCC ≤&#xa0;3&#xa0;cm, OS was similar between the groups but RFS significantly improved in the preoperative TACE group both before (OS: <i>p</i>&#xa0;=&#xa0;0.44; RFS: <i>p</i>&#xa0;&lt;&#xa0;0.001) and after (OS: <i>p</i>&#xa0;=&#xa0;0.84; RFS: <i>p</i>&#xa0;&lt;&#xa0;0.001) PSM. For HCC 3–5&#xa0;cm, both OS and RFS significantly improved in the preoperative TACE group, both before (OS: <i>p</i>&#xa0;=&#xa0;0.038; RFS: <i>p</i>&#xa0;&lt;&#xa0;0.001) and after (OS: <i>p</i>&#xa0;=&#xa0;0.038; RFS: <i>p</i>&#xa0;&lt;&#xa0;0.001) PSM. For HCC &gt;&#xa0;5&#xa0;cm, OS was not significantly different but RFS improved in the preoperative TACE group both before (OS: <i>p</i>&#xa0;=&#xa0;0.42; RFS: <i>p</i>&#xa0;=&#xa0;0.002) and after (OS: <i>p</i>&#xa0;=&#xa0;0.42; RFS: <i>p</i>&#xa0;=&#xa0;0.004) PSM. Additionally, complete lipiodol uptake was associated with better OS (<i>p</i>&#xa0;=&#xa0;0.032) and RFS (<i>p</i>&#xa0;=&#xa0;0.045) in tumors 3–5&#xa0;cm compared with incomplete lipiodol uptake. Multivariate analysis identified preoperative TACE and complete lipiodol uptake as significant factors in improving RFS.</p> Conclusion <p>Preoperative TACE, achieved as complete lipiodol uptake as possible, is recommended to prevent postoperative recurrence of resectable solitary HCC, particularly for tumors measuring 3–5&#xa0;cm, due to the clear survival benefits in both OS and RFS.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Preoperative Transarterial Chemoembolization for Resectable Single Hepatocellular Carcinoma: A Single-Center Cohort Study

  • 期刊论文

  • 发表日期：

    2025年4月6日

查看全文
  • Sang-Hoon Kim,
  • Ki-Hun Kim,
  • Shin Hwang,
  • Chul-Soo Ahn,
  • Deok-Bog Moon,
  • Tae-Yong Ha,
  • Gi-Won Song,
  • Dong-Hwan Jung,
  • Gil-Chun Park,
  • Young-In Yoon,
  • Woo-Hyoung Kang,
  • Eun-Kyoung Jwa,
  • Byeong-Gon Na,
  • Sung Min Kim,
  • Sung-Gyu Lee

摘要

Background

The efficacy of preoperative transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) remains unclear. This study aimed to investigate the impact of preoperative TACE for resectable solitary HCC.

Methods

This retrospective study included 4899 patients who underwent hepatectomy from 2008 to 2019. Survival outcomes were compared before and after propensity score matching (PSM) based on tumor size (≤ 3, 3–5, and > 5 cm) between the preoperative TACE (n = 378) and upfront surgery groups (n = 4521). Cox regression analysis was utilized to identify predictors of overall survival (OS) and recurrence-free survival (RFS).

Results

For HCC ≤ 3 cm, OS was similar between the groups but RFS significantly improved in the preoperative TACE group both before (OS: p = 0.44; RFS: p < 0.001) and after (OS: p = 0.84; RFS: p < 0.001) PSM. For HCC 3–5 cm, both OS and RFS significantly improved in the preoperative TACE group, both before (OS: p = 0.038; RFS: p < 0.001) and after (OS: p = 0.038; RFS: p < 0.001) PSM. For HCC > 5 cm, OS was not significantly different but RFS improved in the preoperative TACE group both before (OS: p = 0.42; RFS: p = 0.002) and after (OS: p = 0.42; RFS: p = 0.004) PSM. Additionally, complete lipiodol uptake was associated with better OS (p = 0.032) and RFS (p = 0.045) in tumors 3–5 cm compared with incomplete lipiodol uptake. Multivariate analysis identified preoperative TACE and complete lipiodol uptake as significant factors in improving RFS.

Conclusion

Preoperative TACE, achieved as complete lipiodol uptake as possible, is recommended to prevent postoperative recurrence of resectable solitary HCC, particularly for tumors measuring 3–5 cm, due to the clear survival benefits in both OS and RFS.