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The role of adjuvant TACE after curative liver resection for HCC. Anthony Fong Prince of Wales Hospital. Hepatocellular Carcinoma. 1. Surgeon. 2005 Jun;3(3):210-5. The continuing challenge of hepatic cancer in Asia. Lai EC, Lau WY. J Am Coll Surg. 2007 Jul;205(1):27-36.
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Prince of Wales Hospital
1. Surgeon. 2005 Jun;3(3):210-5.
The continuing challenge of hepatic cancer in Asia.
Lai EC, Lau WY. J Am Coll Surg. 2007 Jul;205(1):27-36.
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2002. CA Cancer J Clin 2005; 55: 74–108
5th most common cancer in the world
> 500,000 new cases per year
600,000 people die globally due to HCC each year
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J Am Coll Surg. 2007 Jul;205(1):27-36.
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Survival benefit in un-resectable HCC
? TACE as an adjuvant treatment
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Patient selection – tumor extent
Timing for TACE
p = 0.5327
p = 0.04
p = 0.10
p = 0.345
p = 0.004
p = 0.048
p = 0.0094
4 weeks after hepatectomy
Single course already showed survival benefit
Doxorubicin (Adriamycin) / Epirubicin
Cisplatin / Carboplatin
Cleared rapidly by the liver. Large difference in concentration between the liver and systemic circulation
Effective primarily at high doses
Nausea / vomiting
Impaired liver function
2 Patients had recurrence (15%)
Both from lung metastasis
Disease free survival : 3 mths / 15 mths
1 mortality from recurrence (Overall survival 15mths)
Role of adjuvant TACE after curative liver resection is still controversial
Some trials showed promising results in patients with advanced disease
TACE is well tolerated in most studies
Need further large scale study for evaluation