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Comparison of the effects of postoperative prophylactic transcatheter arterial chemoembolization (TACE) and transhepatic arterial infusion (TAI) after hepatectomy for primary liver cancer.

PURPOSE
To explore the impact of transcatheter arterial chemoembolization (TACE) and transhepatic arterial infusion (TAI) on the therapeutic effect of postoperative prophylactic hepatic artery interventional therapy after hepatectomy for primary liver cancer (PLC).


METHODS
This study was conducted on 93 patients who had undergone hepatectomy for PLC and received prophylactic interventional treatment within 1 to 3 months after hepatectomy. These patients were divided into two groups: TACE (n=50) and TAI (n=43). The TACE group was treated with lipiodol-chemotherapy drug emulsion, and the TAI group received chemotherapeutics infusion only. The differences of postoperative tumor recurrence and impact on liver function were compared between the two groups.


RESULTS
There were no significant differences between the two groups with regard to sex, age, liver function Child-Pugh score, preoperative tumor size, preoperative serum alpha-fetoprotein (AFP) and other factors. Clinical overall remission rates (82 vs 76%), recurrence rates (12.2 vs 16.2%) and mean hospital stay (6.31±1.98 vs 5.98±2.02 days) of the TACE group and TAI group showed no obvious differences. However, the disease-free survival (DFS) of the TACE group was remarkably higher than that of the TAI group (23.60±3.56 vs 16.95±2.67 months). Both TACE and TAI caused transient liver dysfunction, but compared with TAI, TACE resulted in more severe liver function injury.


CONCLUSIONS
No significant differences between TACE and TAI groups were noticed in overall remission and recurrence rate, but TACE showed a better performance in prolonging DFS than TAI. Compared with TAI, TACE leads to more serious but transient liver dysfunction. Concerning the impact of TACE and TAI on recurrence after PLC operation, further studies are needed to reach more reliable conclusions.