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Is Preoperative Transarterial Chemoembolization Needed for a Resectable Hepatocellular Carcinoma?

Authors
 Gi-Hong Choi  ;  Dong-Hyun Kim  ;  Byong-Ro Kim  ;  Woo-Jung Lee  ;  Jin-Sub Choi  ;  Kyung-Sik Kim  ;  Chang-Moo Kang 
Citation
 World Journal of Surgery, Vol.31(12) : 2370-2377, 2007 
Journal Title
 World Journal of Surgery 
ISSN
 0364-2313 
Issue Date
2007
Abstract
BACKGROUND: Whether preoperative transarterial chemoembolization (TACE) has the therapeutic benefits in patients with resectable hepatocellular carcinoma (HCC) remains uncertain. MATERIALS AND METHODS: We retrospectively investigated the influence of preoperative TACE on both disease-free survival and the pattern of recurrence after curative resection. From March 1998 to January 2005, a series of 273 patients who underwent curative resection for HCC were reviewed. Altogether, 120 patients underwent preoperative TACE, and 153 patients did not. We compared disease-free survival and the recurrence patterns between TACE and non-TACE groups, as well as between subgroups, stratified with regard to initial tumor size (< or =3 cm, 3-5 cm, >5 cm) and pathologic tumor stage (stage I-II and stage III-IVa). We also compared disease-free survival and the pattern of recurrence among the three groups: complete necrosis, incomplete necrosis, non-TACE groups. RESULTS: The 1-, 3-, and 5-year disease-free survival rates were 76.0%, 57.7%, and 51.3%, respectively, in the TACE group and 70.9%, 53.8%, and 46.8%, respectively, in the non-TACE group. No significant difference was observed in disease-free survival or the pattern of recurrence between the TACE and non-TACE groups. Further analysis of disease-free survival and the pattern of recurrence between subgroups according to initial tumor size and tumor stage showed no significant differences. Complete necrosis of tumor was recognized in only 33 patients of the TACE group (p = 0.001). Among the three complete necrosis, incomplete necrosis, and non-TACE groups, no significant difference was observed in disease-free survival or the pattern of recurrence. CONCLUSIONS: Preoperative TACE did not significantly improve the disease-free survival or the pattern of recurrence after curative resection of HCC. Even though this study is a retrospective analysis, preoperative TACE cannot be recommended as a routine procedure before hepatectomy for a resectable HCC.
Full Text
http://link.springer.com/article/10.1007%2Fs00268-007-9245-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
김동현(Kim, Dong Hyun)
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
최기홍(Choi, Gi Hong) ORCID logo https://orcid.org/0000-0002-1593-3773
최진섭(Choi, Jin Sub)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97450
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