Transcatheter Arterial Chemoembolization Combined with Interferon-α is Safe and Effective for Patients with Hepatocellular Carcinoma after Curative Resection

Abstract

<br/><b>Objectives</b>: Intrahepatic recurrence is the major cause of death among patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative surgical resection. Several approaches have been reportedto decrease the recurrence rate. The objective of our study was to compare the clinical effects of transcatheterarterial chemoembolization (TACE) combined with interferon-alpha (IFN-α) therapy on recurrence after hepaticresection in patients with HBV-related HCC with that of TACE chemotherapy alone. <br/><b>Methods</b>: We retrospectivelyanalyzed the data from 228 patients who were diagnosed with HBV-related HCC and underwent curative resectionbetween January 2001 to December 2008. The patients were divided into TACE (n = 126) and TACE-IFN-α (n= 102) groups for postoperative chemotherapy. The TACE regimen consisted of 5-fluorouracil (5-FU), cisplatin(DDP) , and the emulsion mixed with mitomycin C (MMC) and lipiodol. The recurrence rates, disease-freesurvival (DFS), overall survival (OS), and risk of recurrence were evaluated. <br/><b>Results</b>: The clinicopathologicalparameters and adverse effects were similar between the 2 groups (P > 0.05). The median OS for the TACEIFN-α group (36.3 months) was significantly longer than that of the TACE group (24.5 months, P < 0.05). The3-and 5-year OS for the TACE-IFN-α group were significantly longer than those of the TACE group (P < 0.05)and the recurrence rate was significantly lower (P < 0.05). The TACE and IFN-α combination therapy, activehepatitis HBV infection, the number of tumor nodules, microvascular invasion, liver cirrhosis, and the BCLCstage were independent predictors of OS and DFS. <br/><b>Conclusions</b>: The use of the TACE and IFN-α combinationchemotherapy after curative hepatic resection safely and effectively improves OS and decreases recurrencein patients with HBV-related HCC who are at high risk. Our findings can serve as a guide for the selection ofpostoperative adjuvant chemotherapy for patients with HBV-related HCC who are at high risk of recurrence.