Postoperative adjuvant arterial infusion chemotherapy for patients with hepatocellular carcinoma.

BACKGROUND/AIMS The efficacy of postoperative hepatic arterial infusion chemotherapy (PAI) in the prevention of the recurrence of hepatocellular carcinoma (HCC) following hepatic resections was examined. MATERIAL AND METHODS Between November 1982 and February 1994, hepatic resections were carried out in 74 consecutive HCC patients with stage III and IV at Oita Medical University Hospital. They were divided into two groups. In PAI group patients (n = 26), cis-diamminedichloroplatinum or a combination of 5-fluorouracil, adriamycin and mitomycin was alternately infused every 3 months. The remaining patients who did not receive PAI therapy served as the control (n = 48). The patient survival and disease-free survival of the two groups were compared. RESULTS The cumulative survival rates in the PAI group (90.3%, 71.3%, and 71.3% at 1, 2, and 3 years after hepatectomy, respectively) were significantly higher than those in the control (67.2, 41.7%, and 32.0%, respectively, p < 0.05). The disease-free survival rate in the PAI group (62.9%, 50.3%, and 26.8% at 1, 2, and 3 years after hepatectomy, respectively) was also significantly higher relative to the control (38.6%, 21.7%, and 12.1%, respectively, p < 0.01). CONCLUSIONS Our data indicate that PAI can be efficacious in preventing postoperative recurrence of carcinoma and may lead to a prolonged survival of advanced HCC patients following hepatic resection.