The value of portal vein chemotherapy after radical resection in delaying intrahepatic recurrence of stage II primary hepatocellular carcinoma

BACKGROUND OBJECTIVE: Hepatectomy is now considered as the most effective treatment for hepatocellular carcinoma (HCC). High recurrence rate after operation is the main factor to impact the curative effect. The options of treatment for preventing postoperative recurrence of HCC are controversial. This study was to explore the value of postoperative portal vein chemotherapy (PVC) in delaying recurrence of stage Ⅱ HCC, and to evaluate the risk factors of recurrence. METHODS: A total of 51 patients with pathologically proved stage Ⅱ HCC, who underwent radical resection from February 2003 to February 2007 in Xinjiang Tumor Hospital, were randomly divided into two groups: 24 underwent radical resection alone (control group), and 27 underwent prophylactic PVC after operation (study group). Disease-free survival statuses and median survival time of the patients were analyzed by Kaplan-Meier method; clinical and pathologic factors such as number of nodules, portal vein tumor thrombus, cirrhosis, differentiation level, prophylactic PVC were analyzed by Cox model. RESULTS: The 6-month, 1-, 2- and 3-year disease-free survival rates were 44.4%, 38.9%, 19.4% and 14.3% in control group, and 75.4%, 61.3%, 49.0% and 31.5% in study group. The median survival time was significantly higher in study group than in control group (15.5 months vs. 5.6 months, P0.05). Cox multivariate analysis showed that number of nodules, portal vein tumor thrombus, and PVC were impact factors of the recurrence for stage Ⅱ HCC ( P0.05). Furthermore, PVC significantly increased the 1- year disease-free survival rate of stage Ⅱ HCC patients after operation. CONCLUSION: Prophylactic PVC can delay early recurrence of stage Ⅱ HCC with multiple lesions or portal vein tumor thrombus.