| Objective: To evaluate the efficacy of adjuvant transarterial chemoembolization(TACE)after R0 hepatectomy(RH)in hepatocellular carcinoma(HCC)patients with microvascular invasion(MVI).Methods: From January 2012 to October 2018,100 HCC patients with MVI who underwent adjuvant TACE after RH or RH alone were studied retrospectively.Recurrence-free survival(RFS)and Overall survival(OS)at 1 and 3 years were compared between two groups.Univariate and multivariate Cox proportional hazards regression analyses were performed to identify the independent prognostic factors to RFS and OS.Results: The two groups showed similar RFS at 1,3 years(TACE vs RH: 45.5% vs 47.8%,P=0.989;26.7% vs 31.6%,P=0.793),and similar OS at 1,3 years(TACE vs RH: 84.8% vs 76.1%,P=0.310;46.7% vs 55.3%,P=0.744).Subgroup analysis showed that TACE was associated with significantly worse OS at 3 years among patients with tumor diameter ≤5cm(50.0% vs 89.5%,P=0.015).Multivariate Cox regression showed multiple tumors(HR,2.147;95%CI,1.119-4.119;P=0.021)and preoperative GGT >89.5U/L(HR,2.264;95%CI,1.165-4.399;P=0.016)were significantly associated with early recurrence(<1 year),Tumor diameter >5cm(HR,5.758;95%CI,1.234-26.874;P=0.026)and preoperative GGT >89.5U/L(HR,3.383;95%CI,1.328-8.620;P=0.011)were significantly associated with poor OS at 1 years.Conclusion: TACE after RH could not offer better RFS and OS for HCC patients with MVI than RH alone and could lead to worse OS at 3 years for MVI-HCC patients with tumor diameter ≤ 5cm.MVI-HCC patients with multiple tumors and higher preoperative GGT levels are more likely to generate early recurrence.MVI-HCC patients with larger tumor diameter and higher preoperative GGT level may have worse OS. |
