The Negative Effect of Preoperative Transcatheter Arterial Chemoembolization on Long-Term Outcomes for Resectable Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Yonago Acta Med. 2016 Dec 26;59(4):270-278. eCollection 2016 Dec.

Abstract

Background: Preoperative transcatheter arterial chemoembolization (TACE) is administered to improve long-term outcome after surgical resection of hepatocellular carcinoma (HCC). However, the survival benefit of preoperative TACE is controversial. We conducted a retrospective case-control study to evaluate the effect of preoperative TACE on prognosis.

Methods: A total of 121 patients who underwent curative resection of HCC were divided into two groups according to whether they received preoperative TACE. We determined the control group (n = 34) and TACE group (n = 34) through propensity score matching. The primary endpoint of this study was overall survival, and the secondary endpoints were recurrence-free survival.

Results: The overall survival rate and the recurrence free survival rate were significantly lower in the TACE group than in the control group (P = 0.014 and P = 0.043, respectively). Furthermore, recurrence free survival within less than 2 years after resection was significantly worse in the TACE group than in the control group (P = 0.035).

Conclusion: Preoperative TACE seemed to worsen the long-term outcomes of the patients who underwent surgical resection for the treatment of resectable HCC. Therefore, preoperative TACE should not be considered as a standard therapy in patients with resectable HCC.

Keywords: hepatectomy; neoadjuvant; surgical resection; survival.