Background and objective

At present, there are controversies in the treatment for stage III A hepatocellular carcinoma (HCC). This study was to explore the efficacy of hepatectomy-predominant treatment on stage III A HCC.

Methods

From January 2002 till December 2003, 108 stage III A HCC patients were randomized into two groups: 58 underwent hepatectomy (hepatectomy alone group) and 50 underwent hepatectomy with adjuvant transcatheter arterial chemoembolization (TACE) (combination group). The overall survival and tumor-free survival were observed.

Results

The median tumor-free survival for all the patients was 5.0 months (2.0-69.0 months). The 1-, 3- and 5-year tumor-free survival rates were 25.0%, 8.3% and 6.5%, respectively. The median survival for all the patients was 21.0 months (4.0-69.0 months). The 1-, 3- and 5-year overall survival rates were 72.2%, 25.9% and 19.4%, respectively. The median tumor-free survival and 1-, 3-and 5-year tumor-free survival rates for combination group were 7.0 months, 40.0%, 16.0% and 12.0%, respectively; correspondingly, for hepatectomy alone group were 4.0 months, 15.5%, 1.7% and 1.7%, respectively (log-rank=16.01, p < 0.01). The median overall survival, 1-, 3- and 5-year overall survival rates for combination group were 24.5 months, 86.0%, 36.0% and 24.0%, respectively; correspondingly, for hepatectomy alone group were 15.5 months, 60.3%, 17.2% and 13.8%, respectively (log-rank =6.17, p=0.013).

Conclusions

Hepatectomy-predominant treatment has certain effect on stage III A HCC. Hepatectomy plus adjuvant TACE could improve the survival of stage III A HCC patients.