In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 29, No. 5 ( 2014-05), p. 1056-1064
Abstract:
Microvascular invasion ( MVI ) is a well‐known prognostic factor of postoperative recurrence and of overall survival ( OS ) in patients with hepatocellular carcinoma ( HCC ). We compared the treatment outcomes of transarterial chemoembolization ( TACE ) and surgery/radiofrequency ablation ( RFA ) according to the presence of MVI in patients with early or late recurrent HCC that presented as B arcelona C linical L iver C ancer ( BCLC ) stage 0 or A after curative resection for HCC . Methods A consecutive 68 patients with recurrent HCC of BCLC stage 0 or A at our institution between 1998 and 2012 were retrospectively enrolled. We compared the outcomes of patients treated by TACE or surgery/ RFA . Tumor recurrence after curative resection was classified as early (≤ 12 months) or late ( 〉 12 months) recurrence. Results Median tumor size was 1.5 cm (range, 1–10 cm), and 67 (98.5%) had HCCs within the Milan criteria. Median post‐retreatment follow‐up duration was 27 months (range, 1–109 months). Of the 68 patients, 19 (27.9%) underwent surgery/ RFA , 47 (69.1%) TACE , and 2 (2.9%) were lost to follow‐up. After retreatment, TACE showed significantly higher OS and recurrence‐free survival rates than surgery/ RFA in MVI ‐positive patients ( P = 0.03 and P = 0.05, respectively), but not in MVI ‐negative patients ( P = 0.95 and P = 0.98, respectively). In particular, in early recurred MVI ‐positive patients, TACE had a significantly higher OS rate than surgery/ RFA ( P = 0.01). Conclusions TACE may be the more effective treatment option for recurrent HCC of BCLC stage 0 or A than surgery/ RFA in MVI ‐positive patients, especially in those that recur early after curative resection.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2014.29.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2006782-3
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