Effect of resection following downstaging of unresectable hepatocelluar carcinoma by transcatheter arterial chemoembolization

Background  This retrospective study was undertaken to analyze the outcome of hepatic resection in fifty-two patients with unresectable hepatocellular carcinoma (HCC) between January 2004 and December 2008.

Methods  Among these fifty-two patients, the mean diameter of the tumor was 7.9 cm (4.4–15.5 cm, median 8.5 cm) prior to the first transcatheter arterial chemoembolization (TACE). After 1–6 times of TACE (median 2), the median tumor diameter was reduced to 4.2 cm (0–8.4 cm) prior to resection. The duration between the last TACE treatment and sequential resection varied from one to six months (median 2.7 months). Serum α-fetoprotein (AFP) levels were abnormal in thirty-eight out of the fifty-two patients. In AFP producing HCCs, AFP levels returned to normal (≤400 μg /L) in twenty-five out of thirty-eight patients. Hepatic segmentectomy, multiple hepatic segmentectomy or partial hepatic resection were performed in forty-five patients, two underwent extended left hemihepatectomy, and one underwent right posterior branch portal vein thrombectomy. One patient received a right hemihepatectomy and three had left hemihepatectomies.

Results  Complete tumor radiological response (CR) occurred in five patients (9.6%). There were three cases of perioperative mortality in the fifty-two patients (5.8%). One patient underwent salvaged orthotopic liver transplantation, and twenty-one patients observed tumor recurrence within two years. The 1-, 3- and 5-year survival rates of the fifty-two patients were 77.0% (n=40), 55.0% (n=29), and 52.0% (n=28), respectively. The median survival time after surgery was 49 months (95% confidence interval 7.5–52.7 months).

Conclusions  TACE treatment provides a better chance for HCC resection in  patients initially diagnosed with unresectable HCC. Furthermore, liver resection should be performed once the tumor is downstaged to be compatible for successful resection

     

Expression of the MAGE-1 gene in human hepatocellular carcinomas

Objective To further investigate the expression of MAGE-1 gene in hepatocellular carcinom a (HCC). Methods The tumors and adjacent liver tissue from 45 HCC patients and liver tissue from 28 non-HCC patients (16 with liver cirrhosis and 12 with normal liver) were cha racterized by RT-PCR. A 421 bp PCR product from a cDNA fragment spanning exon s 1, 2 and 3 was sequenced. The HLA type was assayed by standard ELISA in 43 HC C patients.Results Thirty-two of 45 tumor tissues from HCC patients expressed MAGE-1 mRNA (71.1% ). In contrast, MAGE-1 mRNA was not detected in adjacent tissues. Three were found to have point mutations at 3 identical sites resulting in the substitutio n of two amino acid residues. The most frequent HLA types in 43 HCC patients we re: HLA-A2, 53.5%; A11, 25.6%; A24, 20.9%; A33, 20.9%; HLA-B13, 28.3% and B35, 23.2%. Expression of HLA-A33 (20.9%) was higher in HCC patients than t hat predicted in the normal Chinese population (8.8%). There was no discer nable correlation between MAGE-1 expression and α-FP level, tumor size and he patitis B or C virus infection. The identification of peptides which are restri cted by haploptypes other than A1 should increase the opportunity for peptide ba sed immunotherapy.Conclusions This study shows that MAGE-1 mRNA is highly expressed in HCC tumor tissue in Ch inese patients. Previously unreported point mutations in the MAGE-1 gene are d escribed and may also provide additional opportunities for immunotherapy.     

The cellular and molecular mechanism of laminin-glycopeptides on anti-metastasis

Ｌａｍｉｎｉｎ(ＬＮ)ｉｓａｍａｊｏｒｎｏｎｃｏｌｌａｇｅｎｏｕｓｇｌｙｃｏｐｒｏｔｅｉｎｉｎｂａｓｅｍｅｎｔｍｅｍｂｒａｎｅｓＩｔｈａｓｂｅｅｎｒｅｐｏｒｔｅｄｔｈａｔＬＮｃｏｕｌｄａｆｆｅｃｔａｎｕｍｂｅｒｏｆｂｉｏｌｏｇｉｃｂｅｈａｖｉｏｒｓｏｆｃａｒｃｉｎｏｍａｃｅｌｌｓｍｅｄｉａｔｅｄｂｙｔｈｅＬＮｒｅｃｅｐｔｏｒｓ1　ＩｔｉｓｋｎｏｗｎｔｈａｔｔｈｅＮｌｉｎｋｅｄｃｏｍｐｌｅｘｔｙｐｅｃａｒｂｏｈｙｄｒａｔｅｃｈａｉｎｓｏｎＬＮａｒｅｉｎｖｏｌｖｅｄｉｎｔｈｅｒｅｃｏｇｎｉｔｉｏｎａｎ…     

Preventive effects of Jiedu Granules (解毒颗粒) combined with Cinobufacini Injection (华蟾素注射液) versus transcatheter arterial chemoembolization in post-surgical patients with hepatocellular carcinoma: A case-control trial

Objective:To investigate the therapeutic effects of Jiedu Granules(解毒颗粒),a Chinese medicine(CM) compound,plus Cinobufacini Injection(华蟾素注射液),which was extracted from skin of Bufo bufo gargarizans Cantor,to prevent the recurrence of hepatocellular carcinoma(HCC) after surgical resection. Methods:In this case-control trial,a total of 120 patients who stayed in Changhai Hospital were enrolled from December 2001 to December 2006.Sixty patients were treated with Jiedu Granules plus Cinobufacini Injection to prevent tumor recurrence after operation(CM group) and 60 patients were treated with transcatheter arterial chemoembolization(TACE) after operation(TACE group).Progression-free survival(PFS) and overall survival (OS) rates were determined to evaluate the therapeutic effects of post-operative management of patients with HCC.Results:PFS in the CM group was 18.07 months[95%confidence interval(CI):12.49-23.65]and the 1-,2-,3-,4-and 5-year PFS rates were 61%,39%,26%,22%and 12%,respectively.PFS in the TACE group was 8.03 months(95%CI:6.63-9.44) and the 1-,2-,3-,4-and 5-year PFS rates were 34%,11%,7%,2%and 0%,respectively.There was significant difference in survival rate between the two groups(P<0.01).The mean survival time(MST) of patients in the CM group was 49.53 months versus 39.90 months of the TACE group.The 1-,2-,3-,4-and 5-year survival rates were 90%,82%,80%,70%and 63%,respectively,in the CM group,and 79%,70%,60%,60%and 36%,respectively,in the TACE group.There was significant difference in survival time between the two groups(P=0.045).Conclusions:Jiedu Granules plus Cinobufacini Injection,a combination that is commonly used for post-operation management of HCC,can postpone tumor recurrence and metastasis, prolong the survival time and increase the survival rate of post-surgical patients with HCC.However,these findings need to be confirmed in a prospective,randomized controlled trial.     

Bladder cancer therapy using combined proliferating cell nuclear antigen antisense oligonucleotides and recombinant adenovirus p53

Objective To evaluate the antitumor efficacy of proliferating cell nuclear antigen antisense oligonucleotide (PCNA-ASO) in combination with recombinant adenovirus p53 (Ad-p53) against bladder cancer EJ and BIU-87 cells in vitro and in vivo.Methods Cells were transfected with Ad-p53 (100 MOI), and PCNA-ASO (1.6 μmol/L) was then introduced into the cells using a cationic lipid (lipofectamine, 20 μl/ml). In vitro and in vivo antitumor effects of combining PCNA-ASO with Ad-p53 were measured using the MTT assay, flow cytometry, clone formation, and a nude mice model. Results The combination of PCNA-ASO and Ad-p53 inhibited cell viability in both the EJ (89.3%) and BIU-87 (78.6%) cell lines. The ability of the cells to form foci was also reduced by 74.8% in EJ cells and by 67.5% in BIU-87 cells (P&lt;0.01). A significant decrease of cells in the S phase (11.4% in EJ cells, 14.6% in BIU-87 cells) and a significant increase of cells in G1 phase (62.2% in EJ, 56.8% in BIU-87) were noted. The mean tumor volume after 7 days of treatment with PCNA-ASO or Ad-p53 in combination decreased to 47.6% or 36.4% of the initial tumor size in the two cell lines respectively. Conclusion These results indicate that combined PCNA-ASO and Ad-p53 in the treatment of bladder cancer with mutant p53 has important therapeutic potential, significantly suppressing the growth of human bladder cancer both in vitro and in vivo.     

Different Wnt-5A gene expressions in the renal cell carcinoma GRC-1 cell line during the cell cycle

ＴｈｅＷｎｔｇｅｎｅｂｅｌｏｎｇｓｔｏａｎｅｖｅｒｅｘｐａｎｄｉｎｇｆａｍｉｌｙｏｆｐｒｏｔｏｏｎｃｏｇｅｎｅｓｔｈａｔｅｘｐｒｅｓｓｉｎｓｐｅｃｉｅｓｒａｎｇｉｎｇｆｒｏｍＤｒｏｓｏｐｈｉｌｉａｔｏｈｕｍａｎｂｅｉｎｇｓ1　Ｗｎｔ5ＡｉｓａｍｅｍｂｅｒｏｆｔｈｅＷｎｔｇｅｎｅｆａｍｉｌｙａｎｄｗａｓｄｅｔｅｃｔｅｄｉｎｄｅｖｅｌｏｐｉｎｇｂｒａｉｎ,ｌｉｍｂｓ,ｇｏｎａｄｓａｎｄｋｉｄｎｅｙｓｉｎｈｕｍａｎ,ｂｕｔｔｈｅｅｘｐｒｅｓｓｉｏｎｏｆＷｎｔ5Ａｗａｓｓｉｇｎｉｆｉｃａｎｔｌｙｈｉｇｈｅｒｉ…     

Short-term Effect of Combined Therapy with Jinlong Capsule(金龙胶囊)and Transcatheter Arterial Chemoembolization on Patients with Primary Hepatic Carcinoma and Its Influence on Serum Osteopontin Expression

<正>Objective:To observe the clinical combination effect of Jinlong Capsule(金龙胶囊,JLC) and transcatheter arterial chemoembolization(TACE) on the patients with primary hepatic carcinoma(PHC) and JLC's influence on serum osteopontin(OPN) expression and elucidate the correlation between the serum OPN level and curative effect of JLC and TACE.Methods:A total of 98 patients with PHC were observed in a randomized controlled trial(RCT).They were assigned to the Chinese medicine(CM) group(53 patients who were treated with TACE and JLC) and the intervention group(45 patients who were treated with TACE only).The serum OPN levels were measured before and after treatment by quantitative sandwich enzyme-linked immunosorbent assay(ELISA).Forty healthy people were assigned to the control group.The clinical efficacy was observed and Karnofsky score(KPS) was graded.Results:The clinical efficacy of the CM group(60.38%) was better than that of the intervention group(40.00%),and the KPS(84.35±12.19) was higher than the intervention group(69.86±11.58)(P0.05).The serum OPN levels before and after treatment in the patients with PHC were significantly elevated compared with those in the control group(P0.01).After treatment,the OPN levels in CM group(117.69±78.50) were significantly lower compared with those in intervention group(151.09±83.90,P0.05).The OPN levels of responders were remarkably lowered than the non-responders after treatment,and the level of OPN in the CM group was lower than the intervention group(P0.05).Conclusions:The short-term clinical efficacy and the quality of life of patients with PHC can be improved by combining JLC with TACE.The serum OPN levels in PHC patients can reflect the curative effect of treatment and the prognosis of the disease.     

Biological function of a novel gene overexpressed in human hepatocellular carcinoma

Objective To clone the full-length of a differentially expressed cDNA fragment, LC27, and study its biological function tentatively. Methods Northern blot was used to analyze the expression pattern of LC27 in hepatocellular carcinoma, matched nontumor liver tissues, fetal liver and normal adult liver tissues, as well as BEL-7402 hepatocellular carcinoma cell line ESTs splicing and 5’ rapid amplification of cDNA ends (5’ RACE) were used to clone the full-length of LC27 cDNA.An antisense oligodeoxynucleotide approach was used to investigate the biological role of the gene in the proliferation of BEL-7402 cells. Results A 2186 bp novel cDNA with an open reading frame encoding a 283 amino acid protein was cloned.Analysis of the deduced amino acid sequence indicated that it is 38% (88/229) identical to human Golgi 4-transmembrane spanning transporter MTP.The gene and the encoded protein was termed hepatocellular carcinoma overexpressed transmembrane protein (hotp) and HOTP, respectively.Hotp mRNA was almost undetectable in normal adult liver and fetal liver tissues.However, it was significantly up-regulated in hepatocellular carcinoma and some matched nontumor liver tissues, as well as BEL-7402 cells.The proliferation of BEL-7402 cells was suppressed by an antisense oligodeoxynucleotide against hotp mRNA at a concentration of 50 μg/ml. Conclusion HOTP may be an integral membrane transporter protein.The overexpression of the gene in hepatocellular carcinoma may play an important role in hepatocarcinogenesis and disease progression.     

Expression of telomerase and its RNA in nasopharyngeal carcinoma

Ｔｅｌｏｍｅｒａｓｅ ,ａｒｉｂｏｎｕｃｌｅｏｐｒｏｔｅｉｎｔｈａｔｐａｒｔｉｃｉｐａｔｅｓｉｎｔｈｅｍａｉｎｔｅｎａｎｃｅｏｆｔｅｌｏｍｅｒｅｌｅｎｇｔｈ ,ｈａｓｂｅｅｎｆｏｕｎｄｃｌｏｓｅｌｙｒｅｌａｔｅｄｔｏｔｈｅｃｅｌｌｉｍｍｏｒｔａｌｉｔｙａｎｄｍａｌｉｇｎａｎｃｙ Ｒｅｃｅｎｔｉｎｖｅｓｔｉｇａｔｉｏｎｓｓｈｏｗｅｄｔｈａｔｔｈｅｒｅｉｓａｈｉｇｈａｃｔｉｖｉｔｙｏｆｔｅｌｏｍｅｒａｓｅｉｎｍｏｓｔｈｕｍａｎｃａｎｃｅｒｓａｓｗｅｌｌａｓｉｎｉｍｍｏｒｔａｌａｎｄｔｕｍｏｒｃｅｌｌｌｉ…     

Molecular and immunohistochemical study of the inactivati on of the p16 gene in primary hepatocellular carcinoma

Ａｌｔｅｒａｔｉｏｎｓｏｆｐ16ｇｅｎｅａｒｅｋｎｏｗｎｔｏｏｃｃｕｒｉｎｍａｎｙｐｒｉｍａｒｙｔｕｍｏｒｓ ,ｉｎｃｌｕｄｉｎｇｍｅｌａｎｏｍａ ,ｐａｎｃｒｅａｔｉｃｃａｎｃｅｒｓ ,ｅｓｏｐｈａｇｅａｌｓｑｕａｍｏｕｓｃｅｌｌｃａｒｃｉｎｏｍａ ,ｂｒａｉｎｔｕｍｏｒｓａｎｄｔｈｅｈｅｍａｔｏｌｏｇｉｃｍａｌｉｇｎａｎｃｉｅｓ 1 5　Ｉｎａｃｔｉｖａｔｉｏｎｏｆｐ16ｇｅｎｅｏｃｃｕｒｓｖｉａｄｉｆｆｅｒｅｎｔｍｅｃｈａｎｉｓｍｓ ,ｉｎｃｌｕｄｉｎｇｔｈｅｈｏｍｏｚｙｇｏｕｓｄｅｌｅｔｉｏｎ,ｐｏｉｎｔ…     

Effect of preoperative transcatheter arterial chemoembolization on apoptosis of hepatocellular carcinoma cells

Ｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ (ＨＣＣ)ｉｓｏｎｅｏｆｔｈｅｍｏｓｔｃｏｍｍｏｎｍａｌｉｇｎａｎｃｉｅｓ ＳｕｒｇｉｃａｌｒｅｓｅｃｔｉｏｎｉｓｒｅｃｏｇｎｉｚｅｄａｓｔｈｅｍｏｓｔｅｆｆｅｃｔｉｖｅｍｅｔｈｏｄｆｏｒｐａｔｉｅｎｔｓｗｉｔｈＨＣＣ Ｕｎｆｏｒｔｕｎａｔｅｌｙ,ｏｎｌｙａｍｉｎｏｒｉｔｙｏｆｐａｔｉｅｎｔｓｃｕｒｒｅｎｔｌｙｄｉａｇｎｏｓｅｄｗｉｔｈＨＣＣｍａｙｂｅｎｅｆｉｔｆｒｏｍｔｈｉｓｒａｄｉｃａｌｏｐｔｉｏｎ Ｔｒａｎｓｃａｔｈｅｔｅｒａｒｔｅｒｉａｌｃｈｅｍ…     

经导管肝动脉化学栓塞术联合无水乙醇注射治疗肝细胞性肝癌疗效分析

目的:对经导管肝动脉化学栓塞术(TACE)联合B超引导下肝脏瘤体内无水乙醇注射术(PEI)治疗肝细胞性肝癌进行疗效分析。方法:将50例肝癌患者随机分为两组,治疗组(24例)予TACE联合PEI治疗,对照组(26例)单用TACE治疗。结果:治疗组6、12、18个月生存率依次为83.33%、54.17%和33.33%,最长生存30个月以上;对照组仅5例生存达12个月以上,生存率为19.23%。经统计学处理有显著性差异(P<0.01)。结论:TACE联合PEI是提高肝细胞性肝癌患者远期生存率较好的治疗方式。     

肝移植前行肝动脉介入栓塞化疗的远期效果分析

目的研究探讨肝移植术前行肝动脉介入栓塞化疗对于术后患者远期疗效的临床价值。方法采取回顾性分析法,选取我
科2009年11月~2011年11月进行肝移植的肝细胞性肝癌（HCC）患者46例,其中24例术前予以肝动脉介入栓塞化疗（TACE）,
22例术前未予以TACE治疗。比较两组患者术后1年的肝功能（ALT和AST水平）、免疫功能（CD3、CD4、CD8、CD4/CD8、NK
细胞、活化T细胞比例）、术后1年和术后2年的累计生存率和无瘤生存率。结果术后1年介入组的肝功能显著优于对照组,P<
0.01,免疫功能显著优于对照组,P<0.05;术后1年介入组和对照组的累计无瘤生存率分别为72%和46%,术后2年介入组和对照
组的累计无瘤生存率分别为57%和33%,P<0.05;术后1年介入组和对照组的累计生存率分别为84%和55%,术后2年介入组和
对照组的累计生存率分别为63%和34%,P<0.05。结论在肝移植前行肝动脉介入栓塞化疗可以显著改善HCC患者术后的肝
功能和免疫功能,提高其无瘤生存率和术后生存率,具有临床应用价值。
     

可切除大肝癌术前行与不行肝动脉插管化疗疗效的临床随机对照研究

目的:采用随机对照研究评价可切除大肝癌术前肝动脉插管化疗(TACE)对术后肝功能恢复及患者生存率的价值。方法:采用随机对照实验的方法,将2001年7月至2003年12月符合纳入标准的108例可切除大肝癌(直径≥5 cm)患者随机分为一期手术组(OP组,n=56)和TACE+手术组(TACE+OP组,n=52)。比较两组患者术中情况,肿瘤切除率,手术前后肝功能变化,术后1、3、5年无瘤生存率及总生存率的差异。结果:术前两组患者基线情况一致。TACE+OP组插管化疗后γ-球蛋白水平明显高于OP组(P=0.046),手术切除后第7天前白蛋白水平明显低于OP组(P=0.031)。OP组平均手术时间明显短于TACE+OP组(P=0.042),肿瘤切除率明显高于TACE+OP组(P=0.017),肿瘤转移患者明显少于TACE+OP组(2vs9,P=0.018)。两组患者术中肝血流阻断时间及出血量以及术后1、3、5年无瘤生存率及总生存率均无统计学差异。结论:可切除大肝癌术前TACE并不能延长术后无瘤生存期及总生存期,且可能促进肿瘤转移,损害肝功能。     

适形放疗联合介入化疗治疗原发性肝癌的临床研究

目的评价肝动脉化疗栓塞（TACE）联合立体适形放射治疗（3DCRT）对原发性肝癌的效果和不良反应。方法自2002-2005年,66例原发性肝癌患者进行随机分组研究,治疗组34例进行TACE联合3DCRT治疗,先行2次TACE治疗,然后行3DCRT,总剂量为45-55Gy,2-5Gy/Fx/周,对照组32例单纯行TACE治疗,共4次。结果治疗组34例患者总有效率为（RR）76.5%（26/34）,对照组为（RR）46.9%（15/32）;治疗组和对照组1、2、3年生存率分别为61.8%、41.2%和29.4%比46.9%、18.8%、6.3%。两组总有效率（RR）、1年生存率差异无统计学意义（P〉0.05）,2年生存率、3年生存率差异有统计学意义（P〈0.05）。两组不良反应相似。结论TACE结合3DCRT治疗原发性肝癌能明显提高临床治疗效果,而不良反应未见增加。     

Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of two cases and literature review

Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. To our knowledge, only 11 cases have been previously reported. We recently encountered two cases of CLE in our clinical work. Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided. The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE. More caution should be taken in these situations.

     

Prognostic significance of neutrophil to lymphocyte ratio in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

Background Accumulating evidence indicates that systemic inflammation response is associated with the prognosis of various cancers. The aim of this study was to investigate the neutrophil-lymphocyte ratio (NLR), which is one of the systemic inflammation markers, in the prognosis of hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE).

Methods The clinical data of 178 HCC patients who received TACE were retrospectively analyzed. The optimal NLR cutoff was determined according to the receiver operating characteristic (ROC) analysis. All patients were divided into NLR-normal group and NLR-elevated group according to the cutoff, and the clinical features of these two groups were comparatively analyzed. Meanwhile, the overall survival and disease free survival (DFS) were analyzed using the Kaplan-Meier method. The risk factors of postoperative survival were investigated using univariate and multivariate Cox regression analyses.

Results The optimal NLR cutoff was defined at 1.85 and 42 (23.6%) patients had an elevated NLR (NLR>1.85). The median survival time was 9.5 months (range 1–99 months). The clinical data between the two groups were comparable, except for α-fetoprotein. Follow-up results showed that the median survival of patients with normal NLR was 17.5 months (range: 1–99 months) compared with 8 months (range: 8–68 months) of patients with elevated NLR. The 1, 3 and 5-year overall survival of patients in the NLR-normal group and NLR-elevated group were 57.3%, 44.1%, and 27.2% and 42.1%, 19.6%, and 9.5% respectively (χ2=194.2, P <0.001). Similarly, the disease free survival also has a significant difference (χ2=39.3, P <0.001). Multivariate Cox regression analysis showed that a high NLR was an independent factor affecting the survival rate of HCC after TACE (P=0.04).

Conclusion Preoperative NLR was an important prognostic factor to predict the prognosis of patients with intermediate HCC treated with TACE.

     

VEGF在肝癌经肝动脉栓塞化疗术后的表达及临床意义

目的探讨血管内皮生长因子(vascularendothelialgrowthfactorVEGF)在肝癌经肝动脉栓塞化疗(transcatheterhepaticarterialchemoembolizationTACE)术后复发和转移中的作用。方法选取经TACE治疗后2期切除的肝癌标本29例,以同期单纯手术切除的30例标本作为对照,采用免疫组织化学和图像分析的方法检测VEGF的表达。结果TACE治疗组与单纯手术组的VEGF吸光度值分别为(0.149±0.021)和(0.134±0.018),前者明显高于后者(P<0.05)。结论VEGF的高表达可能是引起TACE术后高复发和转移率的一个重要原因。     

Efficacy of postoperative antiviral combined transcatheter arterial chemoembolization therapy in prevention of hepatitis B-related hepatocellular carcinoma recurrence

Background  Recurrence of hepatitis B-related hepatocellular carcinoma (HCC) after curative resection is the leading factor influencing the prognosis of the disease. Therefore, further improvement of long-term survival may depend on the prevention and treatment of the recurrent tumor. The aim of this research was to investigate the role of antiviral therapy and postoperative transcatheter arterial chemoembolization (TACE) in the prevention and treatment of hepatitis B-related HCC recurrence.

Methods  One hundred and twenty patients who underwent curative resection of hepatitis B-related HCC between January 2005 and June 2008 at our hospital were enrolled. Patients were divided into four groups according to the post-operative adjuvant therapy they received, i.e., control, antiviral therapy group, TACE group, and combined group. The disease-free survival (DFS) and the 12-, 24-, 36-month cumulative recurrence rates were studied.

Results  There was no significant difference between isolated postoperative antiviral therapy group and control in terms of disease-free survival (P=0.283), while it was significantly higher in the TACE group compared to control (P=0.019). In all patients, however, viral prophylactic therapy combined with/without TACE brought a favorable result compared to those only with/without TACE (P <0.001). Similarly, no matter combined with or without antiviral treatment, postoperative TACE prolonged DFS (P=0.015). Naturally, a combination of viral prophylactic therapy on the baseline TACE significantly benefited patients’ postoperative DFS (P=0.047) and vice verse (P=0.002). The 24-month cumulative recurrence rates of combined group were significantly lower than that of isolated control group and antiviral therapy (P <0.001 and P=0.011 respectively). However, 36-month recurrence rate was significantly different in the control group compared to the TACE group and combined group (P=0.040 and 0.002 respectively); same as the antiviral group compared to the combined group (P=0.034).

Conclusions  Post-operative TACE prevents early recurrence while antiviral therapy prevents late recurrence of HCC. Combination of antiviral therapy and TACE are suggested for prevention in HCC patients with high risk of recurrence.