Comparison of efficacy of different local therapies for patients with hepatocellular carcinoma recurrence after radical resection

doi:10.3877/cma.j.issn.2095-3232.2018.04.012

Abstract

Abstract:

Objective

To compare the efficacy of several local therapies for patients with hepatocellular carcinoma (HCC) recurrence after radical resection.

Methods

Clinical data of 78 patients with HCC recurrence after radical resection in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2012 to June 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 72 males and 6 females, with an age of 25-73 years, median age of 52 years and 185 recurrent lesions. The patients were divided into 2 groups according to the diameter (D) of focal lesion first relapsed after operation: group D<3 cm (n=55) and group D≥3 cm (n=23). Meanwhile, lesion D<3 cm were divided into 3 subgroups according to different treatments: group microwave (MWA, 97 lesions), group MWA+TACE (21 lesions) and group TACE (35 lesions). Survival analysis was performed using Kaplan-Meier survival curve and Log-rank test, and rates were compared using Chi-square test.

Results

The total survival of group D<3 cm was significantly better than that of group D≥3 cm (χ²=12.65, P<0.05). The 2- and 3-year survival and marked improvement rate of group D<3 cm were 98.11%, 80.00% and 78.18%, respectively, and those of group D≥3 cm were 73.91%, 47.82% and 39.13%, respectively, where significant differences were observed (χ²=11.69, 8.07, 11.13; P<0.05). The 1-, 2- and 3-year efficacy maintenance rate of group MWA was 63.91%, 48.45% and 22.68%, respectively, and those of group TACE was 17.14%, 14.29% and 5.71%, respectively. Their efficacy and marked improvement rate were 98.97%, 93.81% and 85.71% and 62.86%, respectively. The 1- and 2-years efficacy maintenance rate of group MWA were significantly better than those of group TACE (χ²=22.53, 10.49; P<0.05/3). The efficacy and marked improvement rate of group MWA were significantly better than those of group TACE (χ²=10.41, 20.00; P<0.05/3).

Conclusions

The prognosis of patients with HCC recurrence after radical resection is closely related to the diameter of recurrent lesion. The prognosis of patients with a lesion diameter <3 cm is better than that of patients with a lesion diameter≥3 cm. For patients with lesion diameter <3 cm, MWA can be first considered as a local treatment.

Key words: Carcinoma, hepatocellular, Hepatectomy, Catheter ablation, Chemoembolization, therapeutic

Yao Chen, Yifa Chen, Chenran Dao, Ablat Alimu-Jiang, Xiaoping Chen. Comparison of efficacy of different local therapies for patients with hepatocellular carcinoma recurrence after radical resection[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(04): 305-310.

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References 25

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参数		D<3 cm组	D≥3 cm组	统计值	P值
性别		?	?	χ²=0.05	>0.05
?	男	51	21	?	?
?	女	4	2	?	?
年龄（岁）		51±11	50±10	t=0.40	>0.05
乙型病毒性肝炎（例）		53	22	χ²=0.02	>0.05
Child-Pugh分级		?	?	χ²=0.02	>0.05
?	A	53	22	?	?
?	B	2	1	?	?
?	C	0	0	?	?
AFP≥200 μg/L		16	8	χ²=0.25	>0.05
首次复发灶（个）		?	?	χ²=0.98	>0.05
?	单发	46	17	?	?
?	多发	9	6	?	?

参数		D<3 cm组	D≥3 cm组	统计值	P值
性别		?	?	χ²=0.05	>0.05
?	男	51	21	?	?
?	女	4	2	?	?
年龄（岁）		51±11	50±10	t=0.40	>0.05
乙型病毒性肝炎（例）		53	22	χ²=0.02	>0.05
Child-Pugh分级		?	?	χ²=0.02	>0.05
?	A	53	22	?	?
?	B	2	1	?	?
?	C	0	0	?	?
AFP≥200 μg/L		16	8	χ²=0.25	>0.05
首次复发灶（个）		?	?	χ²=0.98	>0.05
?	单发	46	17	?	?
?	多发	9	6	?	?

组别	病灶数	有效率	显效率	疗效维持率
组别	病灶数	有效率	显效率	1年	2年	3年
MWA组	97	98.97	93.81	63.91	48.25	22.68
MWA+TACE组	21	100.00	95.24	76.19	38.09	19.04
TACE组	35	85.71	62.86	17.14	14.29	5.71
P值^a	?	>0.05/3	>0.05/3	>0.05/3	>0.05/3	>0.05/3
P值^b	?	<0.05/3	<0.05/3	<0.05/3	<0.05/3	>0.05/3
P值^c	?	>0.05/3	<0.05/3	<0.05/3	>0.05/3	>0.05/3

组别	病灶数	有效率	显效率	疗效维持率
组别	病灶数	有效率	显效率	1年	2年	3年
MWA组	97	98.97	93.81	63.91	48.25	22.68
MWA+TACE组	21	100.00	95.24	76.19	38.09	19.04
TACE组	35	85.71	62.86	17.14	14.29	5.71
P值^a	?	>0.05/3	>0.05/3	>0.05/3	>0.05/3	>0.05/3
P值^b	?	<0.05/3	<0.05/3	<0.05/3	<0.05/3	>0.05/3
P值^c	?	>0.05/3	<0.05/3	<0.05/3	>0.05/3	>0.05/3

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