Background: Prognosis of patients with hepatocellular carcinoma (HCC) with macrovascular invasion is extremely poor even after hepatic resection. Herein, the efficacy of short-term adjuvant hepatic arterial infusion chemotherapy (HAI) for HCC with macrovascular invasion has been studied.
Patients and methods: From 1997 to 2013, 39 patients with HCC (BVp3, Vv3, or B3) undergoing hepatic resection were enrolled(group A: adjuvant HAI, n=21, group B: hepatectomy alone, n=18).
Results: Clinical and demographic characteristics were similar in the 2 groups. Five-year disease-free survival (DFS) rates were 31.0% and 6.2% in group A and group B, respectively (p=0.008). In multivariate analysis for DFS, adjuvant HAI was the only independent prognostic factor (hazard ratio: 0.44, p=0.04). In group A, the intrahepatic recurrence rate was significantly lower (33% vs 72%, p=0.01) compared to group B, but rates of extrahepatic recurrence were similar in the 2 groups (19% vs 22%). The rate of overall survival was marginally higher in group A compared to group B (51% vs 19%, respectively, p= 0.06).
Conclusion: Short-term adjuvant HAI after hepatic resection may significantly improve DFS for HCC patients with macrovascular invasion.