Detailed Abstract
[Liver Best Oral Presentation]
[LV Best OP 2] Preoperative Transcatheter Arterial Chemoembolization for Surgical Resection of Huge Hepatocelluar Carcinoma (≥ 10 cm) A Multicenter Propensity Matching Analysis
Chao LI1, Lei LIANG1, Ming-Da WANG1, Han WU1, Jiong-Jie YU1, Timothy M. PAWLIK2, Wan-Guang ZHANG3, Yao-Ming ZHANG4, Ya-Hao ZHOU5, Wei-Min GU6, Hong WANG7, Ting-Hao CHEN8, Jun HAN1, Hao XING1, Zhen-Li LI1, Wan Yee LAU9, Meng-Chao WU1, Feng SHEN1, Tian YANG
1Department of Hepatic Surgery, Shanghai Eastern Hepatobiliary Surgery Hospital, China
2Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, USA
3Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and
Introduction : Surgical resection for hepatocellular carcinoma (HCC) is potentially curative, but long-term survival remains unsatisfactory. There is currently no effective neoadjuvant or adjuvant therapy for HCC. We sought to evaluate the impact of preoperative transcatheter arterial chemoembolization (TACE) on long-term prognosis after surgical resection of huge HCCs (≥ 10 cm).
Methods : Using a multicenter database, consecutive patients who underwent curative-intent resection for huge HCC without macrovascular invasion between 2004 and 2014 were identified. The association between preoperative TACE with perioperative outcomes, long-term overall survival (OS) and recurrence-free survival (RFS) was assessed before and after propensity score matching (PSM).
Results : Among the 377 enrolled patients, 88 patients (23.3%) received preoperative TACE. The incidence of perioperative mortality and morbidity was comparable among patients who did and did not undergo preoperative TACE (3.4% vs. 2.4%, P=0.704, and 33.0% vs. 31.1%, P=0.749, respectively). PSM analysis created 84 matched pairs of patients. In examining the entire cohort as well as the PSM cohort, median OS (overall cohort: 32.8 vs. 22.3 months, P=0.035, and PSM only: 32.8 vs. 18.1 months, P=0.023, respectively) and RFS (12.9 vs. 6.4 months, P=0.016, and 12.9 vs. 4.1 months, P=0.009, respectively) were better among patients who underwent preoperative TACE versus patients who did not. After adjustment for other confounding factors on multivariable analyses, preoperative TACE remained independently associated with a favorable OS and RFS after resection of huge HCC.
Conclusions : Preoperative TACE did not increase perioperative morbidity or mortality, yet was associated with an improved OS and RFS after liver resection of huge HCC.
Methods : Using a multicenter database, consecutive patients who underwent curative-intent resection for huge HCC without macrovascular invasion between 2004 and 2014 were identified. The association between preoperative TACE with perioperative outcomes, long-term overall survival (OS) and recurrence-free survival (RFS) was assessed before and after propensity score matching (PSM).
Results : Among the 377 enrolled patients, 88 patients (23.3%) received preoperative TACE. The incidence of perioperative mortality and morbidity was comparable among patients who did and did not undergo preoperative TACE (3.4% vs. 2.4%, P=0.704, and 33.0% vs. 31.1%, P=0.749, respectively). PSM analysis created 84 matched pairs of patients. In examining the entire cohort as well as the PSM cohort, median OS (overall cohort: 32.8 vs. 22.3 months, P=0.035, and PSM only: 32.8 vs. 18.1 months, P=0.023, respectively) and RFS (12.9 vs. 6.4 months, P=0.016, and 12.9 vs. 4.1 months, P=0.009, respectively) were better among patients who underwent preoperative TACE versus patients who did not. After adjustment for other confounding factors on multivariable analyses, preoperative TACE remained independently associated with a favorable OS and RFS after resection of huge HCC.
Conclusions : Preoperative TACE did not increase perioperative morbidity or mortality, yet was associated with an improved OS and RFS after liver resection of huge HCC.
SESSION
Liver Best Oral Presentation
Room A 4/5/2019 1:50 PM - 2:00 PM