Detailed Abstract
[Poster Exhibition]
[P016] Who Can Benefit from Adjuvant Transcatheter Arterial Chemoembolization after Surgical Resection of Hepatocellular Carcinoma?
Lei LIANG1, Jiong-Jie YU1, Hai-Ying SUN1, Ming-Da WANG1, Chao LI1, Hao XING1, Jun HAN1, Xin-Fei XU1, Timothy M. PAWLIK2, Wan Yee LAU1, 3, Feng SHEN1, Tian YANG1
1Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, China
2Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, USA
3Faculty of Medicine, the Chinese Universit
Introduction : Although adjuvant transcatheter arterial chemoembolization (TACE) has been used to prevent postoperative recurrence after hepatocellular carcinoma (HCC) resection, the survival benefits of adjuvant TACE remain controversial. To evaluate the effectiveness of adjuvant TACE for HCC, as well as identify patient populations that might benefit from adjuvant TACE.
Methods : The PubMed, Embase, Medline and Cochrane library were systematically searched for studies published before October 2018 that compared adjuvant TACE versus surgery alone for HCC. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Patients with large HCC (≥ 5 cm), multinodular HCC, microvascular invasion (MVI), or portal vein tumor thrombosis (PVTT) were analyzed in subset analyses.
Results : Twenty-five studies with 6,977 patients were included in the analytic cohort. The pooled analysis demonstrated that adjuvant TACE was associated with a better OS and DFS [HR: 0.67 and 0.67, both P < 0.01]. In subgroup analyses, pooled results revealed that adjuvant TACE was associated with an improved OS and DFS in patients with multinodular HCC (HR: 0.79 and 0.31, both P < 0.01), MVI (HR: 0.62 and 0.67, both P < 0.01), or PVTT (HR: 0.49 and 0.58, both P < 0.01), but not among patients with large HCC (≥ 5 cm) (HR: 0.82 and 0.97, both P > 0.20).
Conclusions : Postoperative adjuvant TACE may be effective to improve OS and RFS in selected patients with multinodular HCC, or HCC with MVI or PVTT. Future randomized controlled trials are needed to better define the benefit of adjuvant TACE.
o
Methods : The PubMed, Embase, Medline and Cochrane library were systematically searched for studies published before October 2018 that compared adjuvant TACE versus surgery alone for HCC. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Patients with large HCC (≥ 5 cm), multinodular HCC, microvascular invasion (MVI), or portal vein tumor thrombosis (PVTT) were analyzed in subset analyses.
Results : Twenty-five studies with 6,977 patients were included in the analytic cohort. The pooled analysis demonstrated that adjuvant TACE was associated with a better OS and DFS [HR: 0.67 and 0.67, both P < 0.01]. In subgroup analyses, pooled results revealed that adjuvant TACE was associated with an improved OS and DFS in patients with multinodular HCC (HR: 0.79 and 0.31, both P < 0.01), MVI (HR: 0.62 and 0.67, both P < 0.01), or PVTT (HR: 0.49 and 0.58, both P < 0.01), but not among patients with large HCC (≥ 5 cm) (HR: 0.82 and 0.97, both P > 0.20).
Conclusions : Postoperative adjuvant TACE may be effective to improve OS and RFS in selected patients with multinodular HCC, or HCC with MVI or PVTT. Future randomized controlled trials are needed to better define the benefit of adjuvant TACE.
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SESSION
Poster Exhibition
Room E 4/6/2019 3:00 PM - 3:50 PM