Postoperative transhepatic arterial chemoembolization and portal vein chemotherapy for patients with hepatocellular carcinoma: a randomized study with 131 cases.

OBJECTIVE To explore the value of postoperative transarterial chemoembolization (TACE) and portal vein chemotherapy (PVC) in patients with hepatocellular carcinoma (HCC) in the prevention of recurrence, and to evaluate prognostic factors in a randomized study. METHOD 131 patients with HCC were randomly divided into 3 groups: operation only (group A, n = 45); operation plus TACE (group B, n = 39), and operation plus TACE and PVC (group C, n = 47). Disease-free survival rates as well as prognostic factors were analyzed. RESULTS Most of the side effects and complications related to the operation, catheters and local chemotherapy were liver decompensation (16.1%), catheter obstruction (12.9%), and nausea and loss of appetite (25.8%), respectively. The disease-free survival curves were significantly different between the 3 groups as estimated by the Kaplan-Meier method (p < 0.05). Group C had a significantly higher disease-free survival rate compared to group A (p < 0.05). But no statistical differences were found between groups A and B and groups B and C (both p > 0.05). Tumor number and treatment modalities were independent prognostic factors for HCC patients (p < 0.05). CONCLUSION Postoperative TACE combined with PVC may benefit the survival of patients with HCC. In specialized medical centers, aggressive methods such as TACE and PVC should be attempted on HCC patients without contraindications.