CYFRA21-1、CA199、AFP联合检测对原发性肝癌的诊断价值

目的:探讨血清CYFRA21-1、CA199、AFP联合检测对原发性肝癌(PHC)的诊断价值.方法:对PHC患者65例、肝良性疾病组47例,应用电化学发光免疫分析技术检测其血清AFP、CYFRA21-1、CA199水平.结果: PHC患者血清AFP、CYFRA21-1、CA199阳性率分别为72.3%、44.6% 、41.5%;AFP、 CYFRA21-1、CA199联合检测阳性率显著提高,达93.8%,与单项AFP检测阳性率相比有显著性差异(P<0.05).结论:AFP 、CYFRA21-1和CA199联合检测对原发性肝癌的诊断具有良好的临床应用意义.     

CYFRA21—1、CA199、AFP联合检测对原发性肝癌的诊断价值

目的：探讨血清CYFRA21—1、CA199、AFP联合检测对原发性肝癌（PHC）的诊断价值。方法：对PHC患者65例、肝良性疾病组47例,应用电化学发光免疫分析技术检测其血清AFP、CYFRA21—1、CA199水平。结果：PHC患者血清AFP、CYFRA21—1、CA199阳性率分别为72．3％、44．6％,41．5％;AFP、CYFRA21—1、CA199联合检测阳性率显著提高,达93．8％,与单项AFP检测阳性率相比有显著性差异（P〈0．05）。结论：AFP、CYFRA21—1和CA199联合检测对原发性肝癌的诊断具有良好的临床应用意义。     

肝动脉化疗栓塞术对原发性肝癌患者中性粒细胞与淋巴细胞比值的影响

目的:探讨原发性肝癌患者行肝动脉化疗栓塞术(TACE)前后中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)的变化情况,分析其影响因素.方法:回顾性分析2015年4月至2015年12月住院行TACE的原发性肝癌患者80例,观察患者术前、术后3天、术后2月的NLR变化情况.根据NLR水平进行分组,探讨不同NLR水平与无进展生存期的相关性.结果:术后3天NLR高于术前,差异有统计学意义(P<0.05),术后2月NLR下降至接近术前水平,差异无统计学意义(P>0.05).术前患者高NLR水平主要与术前肿瘤BCLC分期、大小、AFP、血管侵犯有关.术后NLR高水平与术中明胶海绵使用情况有关.术前NLR高水平是影响预后的危险因素.结论:NLR可反应患者肝脏TACE后的炎症变化情况.术前NLR高水平是影响预后的重要指标.     

肝癌患者围手术期外周血甲胎蛋白mRNA表达与术后复发的关系

背景与目的:甲胎蛋白(alpha-fetoprotein,AFP)mRNA是检测肝癌患者外周血中癌细胞常用的标志物。本研究探讨肝癌患者围手术期的外周血中AFPmRNA表达与术后复发的关系。方法:应用巢式PCR和Taq Man MGB探针法PCR定量技术,检测56例肝细胞癌患者术前和术后外周血、15例良性肝占位性病变合并肝硬化患者外周血以及30例健康志愿者外周血AFP mRNA的表达情况。结果:肝癌患者术前外周血AFP mRNA的阳性率为42.9%(24/56),高于良性肝占位合并肝硬化患者的13.3%(2/15)和健康对照的10.0%(3/30),其差异均有统计学意义(P=0.035,P=0.002)。术前AFP mRNA的表达与肿瘤有无肉眼及镜下血管侵犯的相关性有统计学意义(P=0.029,P<0.001)。AFP mRNA阴性患者1、2、3年生存率及无瘤生存率均比AFP mRNA阳性患者术后高(P=0.003,P=0.039)。Cox多因素分析结果显示术前外周血AFP mRNA阳性是预测术后复发的独立因素(P=0.018)。术后患者外周血AFP mRNA的阳性率为37.5%(21/56),术后AFP mRNA的表达与患者各项临床病理特征、预后以及术前AFP mRNA水平的相关性均无统计学意义。结论:肝癌患者术前外周血中AFP mRNA阳性者比AFP mRNA阳性者肿瘤侵袭性更强,术后可能更易复发。     

肝癌根治术治疗原发性肝癌患者的术后生存率及预后影响因素分析

目的:探讨肝癌根治术治疗原发性肝癌（PHC）患者的术后生存率及预后影响因素。方法:回顾性分析2007年1月至2012年9月我院行肝癌根治术治疗的401例原发性肝癌患者术后临床资料及随访数据,通过电话、门诊复诊等方式进行随访。采用Kaplan-Meier法对变量进行生存分析,绘制生存曲线和计算生存率,采用Log-rank法进行单因素分析,采用Cox回归模型进行多因素分析。结果:随访截至2013年2月6日,401例患者失访34例（8.5%）,中位生存时间为53个月,1年生存率为86.9%,3年生存率为58.5%,5年生存率为39.0%。单因素分析表明前白蛋白（PA）、谷草转氨酶（AST）、白蛋白（ALB）、甲胎蛋白（AFP）为肝癌根治术后预后的危险因素,多因素分析显示肝癌根治术后AFP为影响预后的独立危险因素。结论:血清PA、AST、ALB是原发性肝癌根治术后预后的危险因素,血清AFP是预后独立危险因素,临床应该加强随访,定期监测患者血清PA、AST、ALB、AFP水平,及时治疗,以改善患者预后及提高生活质量。     

原发性肝癌手术切除患者预后危险因素分析

目的:分析影响原发性肝癌患者手术切除后总体生存率和无瘤生存率的危险因素.方法:回顾性分析186例手术切除的肝癌患者临床和病理资料,Kaplan-Meier法和log rank检验进行单因素分析,应用Cox比例风险模型进行多因素分析.结果:影响患者总体预后的独立危险因素包括AFP水平、有无包膜、TNM分期、肿瘤分布、血管侵犯和围手术期输血;影响患者无瘤生存的独立危险因素包括性别、AFP水平、有无包膜、TNM分期、肿瘤数目、肿瘤分布和围手术期输血.结论:肝癌手术切除患者预后与肿瘤进展程度以及围手术期大量输血有关.术前积极改善患者凝血功能,术中有效控制出血,减少输血对于改善患者预后可能有积极的作用.     

血清细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶在结肠癌中的表达情况及与预后的关系

目的 探讨血清细胞角蛋白19片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)在结肠癌中的表达情况及与预后关系.方法 检测78例结肠癌患者手术前后CYFRA21-1、NSE的表达水平,术后进行为期1年的随访,统计复发转移情况,比较不同临床特征结肠癌患者术后的血清CYFRA21-1、NSE表达水平,分析影响结肠癌患者术后复发转移的危险因素.结果 结肠癌患者术后血清CYFRA21-1、NSE水平均明显低于手术前(P﹤0.01).术后随访1年,有复发转移25例(32.05%),无复发转移53例(67.95%).单因素分析结果显示,淋巴结转移情况、分化程度、CYFRA21-1水平、NSE水平均可能是结肠癌患者术后复发转移的影响因素(P﹤0.05),肿瘤部位、性别、年龄、饮酒史、吸烟史均可能不是结肠癌患者术后复发转移的影响因素(P﹥0.05).将可能的影响因素带入Logistic回归模型进一步分析,结果显示,有淋巴结转移、分化程度低、术后CYFRA21-1高表达及NSE高表达均是结肠癌患者术后发生复发转移的危险因素(P﹤0.01).结论 血清CYFRA21-1、NSE水平在结肠癌患者中呈高表达,术后血清CYFRA21-1、NSE表达水平则明显下降,且血清CYFRA21-1、NSE表达与患者术后复发转移关系密切,对判断患者预后有重要临床价值.     

血清前白蛋白(PA)含量在肝脏TACE术患者预后中的临床价值

目的:明确肝癌TACE术患者预后的影响因素，探讨术前前白蛋白含量在评估肝癌患者TACE术后远期预后中的价值。方法:回顾性分析上海长海医院中医肿瘤科2012年5月至2017年11月期间行肝脏TACE术的原发性肝癌患者病例资料及随访资料，用单因素分析及多因素回归分析术前多项临床参数对患者生存时间的影响。结果:共342例行肝脏TACE术的肝癌患者纳入研究。肿瘤大小、TNM分期、术前PA水平、血管侵犯是影响患者术后复发的独立危险因素。高PA组中位生存时间为29.4个月，中PA组中位生存时间16.8个月，低PA组中位生存时间为11.0个月,三组组间差异有统计学意义。结论:术前前白蛋白PA含量低是肝癌患者TACE术后总生存期的独立危险因素。     

TACE治疗肝癌前后外周血中AFP mRNA的变化及其意义研究

为探讨原发性肝细胞癌(primary hepatocellular carcinoma,PHC)患者肝动脉化疗栓塞术(transcatheter ar-terial chemoembolization,TACE)前、后周围静脉血液中AFP mRNA的变化及其意义。我们用巢式RT-PCR对21例TACE术的PHC患者进行其每次TACE前1周、后1周外周血中AFP mRNA的检测,以观测其变化。结果示21例PHC患者中首次TACE术前有13例(61.9%)血液中AFP mRNA检测阳性;8例(38.9%)首次TACE术前血液中AFP mRNA检测阴性;13例血液中AFP mRNA阳性患者中,有3例首次TACE后1周时转阴性(23.1%,P>0·05),4周时AFP mRNA转为阴性者共有5例(38.5%,P>0·05),第2次TACE术后1周时血液中AFP mRNA转为阴性者共有7例(53.8%,P>0·05),有6例未转阴(其中5例为肝内外转移者);8例首次TACE术前血液中AFP mRNA阴性者第1次TACE术后1、4周时仍为阴性,有2例在第2次TACE后1周时血液中AFP mRNA出现阳性(25%,P>0·05)。初步研究结果提示,TACE术治疗原发性肝癌对部分肝癌患者可以起到预防或阻止肝癌细胞血液转移的作用;多次TACE(≥2次)有引起肝癌细胞外周血转移的可能;介入期间辅以全身化疗及生物调节剂等综合治疗有必要性。     

肝癌首发部位对患者术后复发的影响

目的探讨肝癌首发部位及联合血清甲胎蛋白(AFP)表达对于预测肝癌患者术后复发及预后的意义。方法回顾性分析2005年3月-2009年10月行肝癌手术并长期随访的256例患者,运用Kaplan-Meier生存曲线分析总体生存率及术后复发率,Logrank检验P值,Cox比例风险模型进行单因素及多因素分析术后复发高危因素。结果肝癌首发部位不同,其术后总体生存率差异有统计学意义(P=0.022),且肝癌首发于全肝或肝左叶组患者较肝右叶组患者具有更高的术后复发风险(P=0.002)。分层分析发现,在AFP阴性(AFP<25 ng/ml)亚组中两者术后复发率差异有统计学意义(P<0.001)。Cox单因素及多因素分析显示远处转移(P=0.016)、血清AFP(P=0.002)及门脉癌栓(P<0.001)可以作为预测肝癌术后复发的独立危险因素,而肝癌首发部位不能作为一个独立的危险因素(P=0.088)。结论肝癌首发部位可以作为一个预测患者术后复发的危险因素。     

经肝动脉化疗栓塞联合射频消融治疗原发性肝细胞癌合并门静脉癌栓的预后影响因素分析

背景与目的：经肝动脉化疗栓塞（transcatheter arterial chemoembolization,TACE)是否为治疗原发性肝细胞癌（hepatocellular carcinoma,HCC）合并门静脉癌栓（portal vein tumor thrombus,PVTT）的绝对禁忌,目前尚无定论。该研究旨在探讨TACE联合射频消融（radiofrequency ablation,RFA）治疗HCC合并PVTT的预后影响因素。方法：回顾性分析2011年1月1日—2013年12月31日于郑州大学附属肿瘤医院行TACE联合RFA治疗的HCC合并PVTT的157例患者的临床资料及随访数据,单因素及多因素Cox回归分析人口学资料、实验室指标及临床资料与生存时间和肿瘤转移复发情况的关系。结果：多因素Cox回归结果显示,在调整和控制其他因素后,血清白蛋白（albumin,ALB）水平为TACE联合RFA治疗后HCC合并PVTT患者3年生存及降低肿瘤复发转移风险的保护性因素,术前甲胎蛋白（alpha-fetoprotein,AFP）、丙氨酸转氨酶（alanine aminotransferase,ALT）、天门冬氨酸转氨酶（aspartate transaminase,AST）水平、门静脉癌栓部位及肝功能Child Pugh分级为患者3年生存的独立危险因素;AFP、AST水平及门静脉癌栓部位为肿瘤复发转移的独立危险因素。结论：TACE联合RFA并非治疗HCC合并PVTT的绝对禁忌,在治疗前对患者进行相关因素评估有助于更好地选择治疗方法和时机,从而提高HCC治疗水平。     

肝癌肝移植的预后因素分析

背景与目的：肝移植（liver transplantation,LT）是目前治疗肝细胞癌（hepatocellular carcinoma,HCC）最好的措施,但影响HCC肝移植预后的主要因素和手术指征始终存在争议。明确影响预后的主要因素有助于确定合理的手术指征,进而提高HCC肝移植的生存率。本研究旨在探讨影响HCC肝移植预后的主要因素。方法：回顾性分析1999年2月至2004年12月在四川大学华西医院施行肝移植的98例HCC患者的临床资料和随访结果。用Kaplan—Meier法计算全组的累积生存率,log-rank检验做单因素分析,Cox比例风险回归模型进行多因素分析。结果：全组随访1—78个月,中位随访时间37．6个月;随访期间死亡31例（31．6％）,51例复发（52．0％）。全组病例1年、3年和5年累积生存率分别为84．9％、49．3％和33．2％。单因素分析显示,肿瘤大小、门静脉癌栓（portal vein tumor thrombus．PVTT）、AFP水平、pTNM分期和组织学分级与预后有关：Cox回归多因素分析显示,肿瘤大小和PVTT是影响预后的独立因素。结论：肿瘤大小和PVTT是影响HCC肝移植预后的最主要因素。     

Prognostic significance of CYFRA21-1, CEA and hemoglobin in patients with esophageal squamous cancer undergoing concurrent chemoradiotherapy

Purpose: To evaluate the prognostic value of serum CYFRA21-1, CEA and hemoglobin levels regardinglong-term survival of patients with esophageal squamous cell carcinoma (ESCC) treated with concurrentchemoradiotherapy (CRT). Methods: Age, gender, Karnofsky Performance Status (KPS), tumor location,tumor length, T stage, N stage and serum hemoglobin, and CYFRA21-1 and CEA levels before concurrent CRTwere retrospectively investigated and related to outcome in 113 patients receiving 5-fluorouracil and cisplatincombined with radiotherapy for ESCC. The Kaplan-Meier method was used to analyze prognosis, the log-rankto compare groups, the Cox proportional hazards model for multivariate analysis, and ROC curve analysis forassessment of predictive performance of biologic markers. Results: The median survival time was 20.1 monthsand the 1-, 2-, 3-, 5- year overall survival rates were 66.4%, 43.4%, 31.9% and 15.0%, respectively. Univariateanalysis showed that factors associated with prognosis were KPS, tumor length, T-stage, N-stage, hemoglobin,CYFRA21-1 and CEA level. Multivariate analysis showed T-stage, N-stage, hemoglobin, CYFRA21-1 and CEAlevel were independent predictors of prognosis. By ROC curve, CYFRA21-1 and hemoglobin showed betterpredictive performance for OS than CEA (AUC= 0.791, 0.704, 0.545; P=0.000, 0.000, 0.409). Conclusions: Ofall clinicopathological and molecular factors, T stage, N stage, hemoglobin, CYFRA21-1 and CEA level wereindependent predictors of prognosis for patients with ESCC treated with concurrent CRT. Among biomarkers,CYFRA21-1 and hemoglobin may have a better predictive potential than CEA for long-term outcomes.     

Prognostic relevance of oncological serum biomarkers in liver cancer patients undergoing transarterial chemoembolization therapy

As transarterial chemoembolization (TACE) therapy is an effective locoregional treatment for patients with advanced liver cancer, prognostic biomarkers are highly needed for pretherapeutic stratification of patients to TACE therapy. Sera of 50 prospectively and consecutively included patients with hepatocellular carcinoma (HCC) undergoing TACE were taken before and 24 h after TACE application. Levels of liver-specific, tumor-related, and cell death biomarkers were analyzed and correlated with overall patient survival. The study was particularly focused on patients treated by TACE with palliative intention (N = 38). Sixteen of 38 patients died within 1 year after TACE, 22 were still alive. In univariate analysis, high levels of cytokeratin 19-fragments (CYFRA 21-1), alpha fetoprotein (AFP), and low choline esterase (CHE) levels measured before and 24 h after TACE were correlated with unfavorable outcome. Further high pretherapeutic lactate dehydrogenase (LDH), aspartate-aminotransferase, and bilirubin levels as well as high 24 h C-reactive protein values were associated with poor survival. In multivariate analysis of clinical and only pretherapeutic biomarkers, AFP, CHE, and LDH showed to be independent prognostic parameters. When additionally 24 h values were included, CHE (24 h) and AFP (24 h) were the strongest independent prognostic biomarkers with a slightly higher prognostic power (Akaike’s information criterion 90.3 vs. 92.7). The combination of AFP, CHE, and LDH enables efficient pretherapeutic stratification of HCC patients in advanced tumor stage for TACE therapy.     

Prognostic factors and treatment effects for hepatocellular carcinoma in Child C cirrhosis

The aim of this study is to elucidate the prognostic factors and the treatment effect on survival in hepatocellular carcinoma (HCC) patients with Child C cirrhosis. Out of 3330 newly discovered HCC patients, 157 consecutive HCC individuals with Child C cirrhosis were enrolled. The prognostic factors were examined by Cox proportional hazards regression analysis and their survival was compared by propensity score-matched analysis. Multivariate analysis revealed that high serum bilirubin (>3 mg dl(-1)), the presence of uncontrollable ascites, and a high platelet count (>8 x 10(4) mm(-3)), so-called background liver factors, as well as multiple tumours, large tumours (>3 cm), high alpha-fetoprotein (>400 ng ml(-1)), and the presence of portal vein thrombus, so-called tumour factors, were factors of poor prognosis. While transcatheter arterial chemoembolisation (TACE) was a factor of good prognosis (relative risk=0.50, 95%CI=0.27-0.89, P=0.019), local ablation therapy and transcatheter arterial chemoinfusion (TAI) were not significant prognostic factors. The survival of patients who received TACE was superior to matched patients without active treatment (P=0.009); however, we did not observe survival benefit after local ablation therapy or TAI. These results suggested that tumour factors as well as background liver factors are prognostic factors of HCC even in patients with Child C cirrhosis, and selective use of TACE in these patients provides survival benefit.     

Prognostic Significance of Preoperative Serum Alphafetoprotein in Hepatocellular Carcinoma and Correlation with Clinicopathological Factors: a Single-center Experience from China

Objectives: To investigate the prognosis significance of preoperative serum alpha-fetoprotein (AFP) andthe correlation with clinicopathological factors of hepatocellular carcinoma (HCC) patients who underwenthepatectomy. Materials and Methods: Clinicopathological data of retrospective analysis were collected for251 HCC patients undergoing hepatectomy in this study. According to preoperative AFP level, patients werecategorized into AFP-negative (0-20ng/mL) and AFP-positive (>20 ng/mL) groups for Kaplan-Meier analysisand Cox proportional hazard regression modeling. Results: The results demonstrated that increased AFPwas associated with longer prothrombin time (PTs), liver capsule invasion, low grade differentiation, and lateBarcelona Clinic Liver Center (BCLC) stage. Moreover, the female patients had a greater prevalence of increasedpreoperative AFP than male patients [284.8 (3.975-3167.5) vs (3.653-140.65); Z-2.895, p=0.004]. The 1-, 3-, and5-year recurrence-free survival (RFS) rates were 78.1, 57.5, and 40.6 % in the AFP-negative group and 61.8,37.7, and 31.4 %, respectively, in the AFP-positive group (log-rank test 8.312, p=0.004). The 1-, 3-, and 5-yearoverall survival (OS) rates were 94.4, 83.8, and 62.3% in the AFP-negative group and 87.2, 60.0, and 36.7%,respectively, in the AFP-positive group. The difference was statistically significant (log-rank test, 16.884, p=0.000).Cox proportional-hazards model identified preoperative AFP to be an independent prognostic predictor of overallsurvival. Conclusions: Preoperative serum AFP is an independent predictor of prognosis among HCC patientsfollowing surgical resection. Female patients have a higher preoperative AFP than their male counterparts.     

8cm以上肝癌术后残癌的肝动脉栓塞化疗预后因素分析

目的：了解肝动脉栓塞化疗对直径大于8cm肝癌术后残癌的疗效和影响预后的因素。方法：肝癌切除术后2个月内经超声和动脉造影证实有残癌的肝癌患者，行肝动脉栓塞化疗；采用COX模型研究影响疗效的因素。结果：治疗后1，2，3，4年生存率为74.9%，44.2%，36.8%，18.4%。肝癌切除术后残癌的TNM分期是影响疗效的独立因素（P=0.003)。而原发癌的肿瘤分期，手术方式（局部切除或肝叶切除），肝动脉栓塞化疗的次数，不是影响预后的独立因素。结论：肝癌术后行肝动脉栓塞化疗是可行的，术后残癌的分期是影响肝动脉栓塞化疗效果的主要因素，大体积肿瘤术后尽早行肝动脉栓塞化疗是必要的。     

Preoperative serum midkine concentration is a prognostic marker for esophageal squamous cell carcinoma

High preoperative serum midkine concentration is associated with poor survival in patients with esophageal cancer, even after radical surgery, and thus may have prognostic value. Midkine (MK), a heparin-binding growth factor, is expressed in numerous cancer tissues, and serum MK (S-MK) concentrations are increased in patients with various neoplasms. The aim of this study is to evaluate the clinical significance of S-MK in patients with esophageal squamous cell cancer (SCC). S-MK was measured by enzyme-linked immunosorbent assay in 135 healthy controls, 16 patients with benign esophageal disease, and 93 patients with primary esophageal SCC before surgery. The serum concentrations of carcinoembryonic antigen (CEA), SCC antigen (SCC-Ag), and cytokeratin 19 fragment (CYFRA21–1) were also evaluated. All patients with esophageal SCC underwent radical esophagec-tomy. Tumor MK expression was assessed by immunohistochemistry in 14 fresh tumor specimens. To determine whether S-MK is of value as a prognostic factor, the authors conducted a survival analysis using Cox's proportional hazards model. S-MK values in patients with esophageal SCC were significantly higher than those in healthy controls (417±342 pg/ml vs. 154±76 pg/ml, P <0.001). Using 300 pg/ml as the cut-off value (representing the mean +2 standard deviations of the S-MK of healthy controls), 61% of patients with esophageal SCC were classified as positive. MK expression by the tumor was significantly associated with high level of S-MK. High S-MK (≥300 pg/ml) was associated with tumor size, immunoreactivity and poor survival. Multivariate analysis indicated that S-MK was an independent prognostic factor. S-MK may be a useful tumor marker for esophageal SCC. Increased preoperative S-MK in patients with esophageal SCC is associated with poor survival.     

肝细胞癌切除术后肝内复发患者的预后影响因素分析

目的 探讨肝细胞癌(HCC)切除术后肝内复发的预后影响因素以及复发后治疗方式的选择.方法 收集184例HCC切除术后肝内复发患者的临床病理资料,回顾性分析21项临床病理学因素以及复发后治疗方式对HCC患者肝内复发后生存期的影响.结果 单因素分析结果 表明,术前血清甲胎蛋白(AFP)水平较高(>100 ng/ml)、有微血管浸润、首次诊断复发时肿瘤的Child-Pugh分级为B或C级、有多个肝内复发肿瘤以及早期肝内复发(≤12个月)的患者预后不良.Cox多因素分析结果 表明,首次诊断复发时肿瘤的Child-Pugh分级、复发肿瘤的数目和复发时间是影响HCC患者复发后生存期的独立危险因素.69例单个复发肿瘤患者中,经再次肝切除手术和局部消融治疗患者的复发后中位生存期分别为34和23个月,而经肝动脉插管化疗栓塞治疗和未进行治疗患者的复发后中位生存期分别为15和9个月,4种治疗方式患者的生存期差异有统计学意义(P<0.05).结论 首次诊断复发时肿瘤的Child-Pugh分级为A级、单个复发肿瘤、复发时间较晚(>12个月)、经过再次肝癌切除手术或局部消融治疗的HCC肝内复发患者的预后较好.     

Postoperative adjuvant transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond the Milan criteria: a retrospective analysis

Objective: To clarify the value of postoperative adjuvant transcatheter arterial chemoembolization (TACE) for resectable multiple hepatocellular carcinoma beyond the Milan criteria. Background: Patients with multiple HCC have been shown to have a worse survival after a partial hepatectomy (PH) because of the high incidence of intrahepatic tumor recurrence. Postoperative adjuvant TACE is an optional strategy for HCC patients with a high recurrence risk. Its effects and range of applications are debatable. Methods: This retrospective study enrolled 135 HCC patients with resectable multiple hepatocellular carcinoma beyond the Milan criteria, and those patients underwent a hepatectomy with/without postoperative adjuvant TACE from Jan. 2004 to Dec. 2008. The patients were divided to the PH cohort or the PH+TACE cohort. The prognosis measures were the disease-free survival (DFS) and overall survival (OS) from the date of treatment. Univariate and multivariate analyses were used to assess the prognostic factors associated with DFS and OS, using the Cox proportional hazards model. Results: The 1-, 2-, and 5-year DFS and OS for the PH+TACE group differed significantly from the PH group (p = 0.004, p = 0.002, respectively). Multivariate analysis revealed that the significant independent risk factors associated with the DFS and OS were postoperative TACE treatment (p = 0.002, p = 0.001, respectively) and the number of tumors (p = 0.006, p = 0.037, respectively). Conclusions: Our results show that postoperative adjuvant treatment resulted in delayed intrahepatic recurrence and better survival for patients with resectable multiple hepatocellular carcinoma beyond the Milan criteria. Postoperative adjuvant TACE should be regarded as a common strategy for patients with resectable multiple HCC beyond the Milan criteria.