Long-term efficacy of transarterial chemoembolization in the treatment of recurrent hepatocellular carcinoma.

[OBJECTIVES] The purpose of this study was to evaluate the efficacy and safety of transarterial chemoembolization (TACE) for the treatment of patients with recurrent HCC after surgical operation (SR-HCC) and to compare the results with those of the patients with recurrent HCC after TACE (TR-HCC).

[METHODS] This retrospective study investigated a series of patients who underwent TACE after recurrence from January 2014 to June 2023 in our medical center. Overall survival (OS), therapeutic response and survival rates were compared between the two groups.

[RESULTS] A total of 236 eligible patients were included in this study, including 139 patients in the TR-HCC group and 97 patients in the SR-HCC group. The objective response rate of TR-HCC patients was 46.0%, and that of SR-HCC patients was 76.3% ( < 0.001). While the disease control rate of TR-HCC patients was 71.9%, and that of SR-HCC patients was 89.6% ( < 0.001). Before PSM, the median OS in the SR-HCC group was significantly greater than that in the TR-HCC group (OS: 41 months vs. 22 months,  = 0.005). After PSM, the median OS was 24 months (95% CI 20 months, 28 months) in the TR-HCC group and 43 months (95% CI 29 months, 55 months) in the SR-HCC group ( = 0.014). Multivariate analysis suggested that aspartate aminotransferase (AST) levels was significantly related to OS.

[CONCLUSION] Patients who experienced recurrence after surgical resection who treated with TACE achieved positive results. And we believe that TACE could be a possible treatment for patients with HCC after surgical resection, especially those who are not suitable for re-resection.