Preoperative transarterial chemoembolization does not improve the outcomes of resectable hepatocellular carcinoma: A propensity score-matched study

Abstract

Background: Transarterial chemoembolization (TACE) is reserved for the treatment of intermediate hepatocellular carcinoma (HCC) (Barcelona Clinic Liver Cancer stage B); however, it can also be utilized as a neoadjuvant treatment prior to surgical resection in resectable HCC cases. This study aimed to clarify the benefits of TACE in patients with resectable HCC. Methods: Data were retrospectively collected from patients with resectable HCC who had undergone hepatectomy between January 2010 and December 2015. A 1:1 propensity-matched case-control study was conducted using a logistic regression model that included the following covariates: sex, age, Model for end-stage liver disease score, and the number and size of tumors. Results: Of 160 patients, 37 and 123 were included in the TACE before liver resection (TACE-LR) and upfront LR groups, respectively. After 1:1 propensity score matching in the LR-matched group (n = 37), no significant differences in baseline parameters were found between the TACE-LR and LR-matched groups. Moreover, there were no significant differences in short-term outcomes, including intraoperative blood loss (800 mL vs. 500 mL, P = 0.148), operative time (300 min vs. 290 min, P = 0.824), and overall morbidity (24.3% vs. 13.51%, P = 0.235) between the TACE-LR and LR-matched groups. As long-term outcomes, no significant between-group differences were found in the 5-year disease-free survival rate (TACE-LR, 38%; LR, 58%; P = 0.89) or the 5-year overall survival rate (TACE-LR, 80.9%; LR, 80.8%; P = 0.72). Conclusion: The short- and long-term outcomes were not significantly different between preoperative TACE and LR for resectable HCC.

Keywords

• carcinoma
• hepatocellular; chemoembolization
• therapeutic; general surgery; survival; treatment outcome