Effects of Preoperative Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma on Survival and Recurrence Depending on the TNM Stage, CLIP and JIS Scores

Kazuhiro Kondo, Kazuo Chijiiwa, Ichiro Makino, Masahiro Kai, Tadaaki Eto and Jiro Ohuchida

Department of Surgery 1, Faculty of Medicine, Miyazaki University

Introduction: In hepatocellular carcinoma (HCC), the advantages of preoperative transcatheter arterial chemoembolization (TACE) on survival and recurrence remain controversial. We studied the significance of preoperative TACE in HCC patients classified by TNM stage based on Liver Cancer Study Group of Japan criteria, the Cancer of the Liver Italian Program (CLIP) score, or the Japan Integrated Staging (JIS) score. Methods: we retrospectively reviewed 204 cases of hepatectomy for hepatocellular carcinoma. Of these, 73 had preoperative TACE (TACE+ group) and 131 did not (TACE-). We evaluated the differences in postoperative survival and recurrence for each stage and score. Results: The TNM stage and CLIP and JIS scores reflected prognosis. TACE had no significant effect on postoperative survival in any TNM stage. Similarly, preoperative TACE showed no significant effect on postoperative survival in CLIP and JIS scores except for CLIP I, where postoperative survival was better in the TACE- group. The period until postoperative recurrence in 42 TACE+ patients and in 63 TACE- was longer in the TACE+ group only in patients with TNM stage III and JIS score 2, and no significant difference was found in other stages and scores. Conclusion: Preoperative TACE had no significant effect on postoperative survival or disease recurrence. The use of preoperative TACE thus does not necessary, but in selected cases it may contribute to elongate the period until postoperative recurrence.

Key words
hepatocellular carcinoma, preoperative transcatheter arterial chemoembolization, TNM stage, CLIP score, JIS score

Reprint requests
Kazuhiro Kondo Department of Surgery 1, Faculty of Medicine, Miyazaki University
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
May 25, 2004

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