The effect of preoperative transarterial chemoembolization of resectable hepatocellular carcinoma on clinical and economic outcomes.

Abstract:

BACKGROUND:Hepatocellular carcinoma (HCC) is one of the most malignant cancers in the world. The effect of preoperative transarterial chemoembolization (TACE) for resectable HCC is still controversial and cost-associated treatments are unknown. METHODS:We retrospectively compared clinical outcomes and resource utilization after liver resection between patients who underwent preoperative TACE (TACE-LR group, n = 114) and those who did not (LR group, n = 236). RESULTS:The overall mortality rate was 27.54% for the LR group versus 39.47% for the TACE-LR group (P < 0.05). The overall recurrent rates were 29.36% for the LR group versus 35.90% for the TACE-LR group (P > 0.05). Multivariate Cox regression analysis showed that preoperative TACE was a significant risk factor (P = 0.002, HR = 1.995, 95% CI 1.297-3.069) for overall long-term survival for HCC. The TACE-LR group had longer mean lengths of stay and higher hospital charges, both at index hospitalization and at 6 months for follow-up. CONCLUSION:Preoperative TACE is not only associated with higher medical utilizations, but it is also correlated with higher mortality rates over a 5-year period. The preoperative TACE does not benefit patients with resectable HCC. The golden standard or clinical guidelines should be developed to provide better clinical decisions and decision support for HCC patients.

journal_name

J Surg Oncol

authors

Lee KT,Lu YW,Wang SN,Chen HY,Chuang SC,Chang WT,Shi HY,Ker CG,Chiu HC

doi

10.1002/jso.21248

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

343-50

issue

6

eissn

0022-4790

issn

1096-9098

journal_volume

99

pub_type

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