BACKGROUND We identified the predictive factors and prognostic significance of transarterial chemoembolization (TACE) for achieving pathologic complete response (pCR) before curative surgery for hepatocellular carcinoma (HCC) in hepatitis B-endemic areas. METHODS Among 753 HCC patients treated with surgery, 124 patients underwent preoperative TACE before liver resection (LR), and 166 before liver transplantation (LT) between 2005 and 2016. Overall survival (OS) and recurrence-free survival (RFS) were analyzed. Pathologic response (PR) was defined as the mean percentage of necrotic area, and pCR was defined as the absence of viable tumor. RESULTS A total of 34 (27%) and 38 (23%) patients had pCR before LR and LT, respectively. Alpha-fetoprotein (AFP) < 100 ng/mL and single tumor were significant preoperative predictors of pCR. OS and RFS were significantly improved in patients with pCR or a PR ≥ 90%, but not in patients with PR ≥ 50% after LR and LT. On multivariate analyses, PR ≥ 90% remained an independent predictor of better OS and RFS in LR and LT groups. CONCLUSION Overall, our data clearly demonstrate that pCR predicts favorable prognosis after curative surgery for HCC, and predictors of pCR are AFP <100 ng/mL and single tumor.

中文翻译：

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对化学栓塞的病理完全反应可改善肝癌根治性手术后的生存结局：反应的预测因素。

背景：我们确定了乙型肝炎流行地区肝细胞癌（HCC）根治性手术前经动脉化学栓塞（TACE）达到病理完全缓解（pCR）的预测因素和预后意义。方法2005年至2016年间，在753例接受手术治疗的HCC患者中，有124例在肝切除术前（LR）和166例在肝移植术前（LT）接受了术前TACE。分析了总生存期（OS）和无复发生存期（RFS）。病理反应（PR）定义为坏死面积的平均百分比，pCR定义为不存在存活的肿瘤。结果分别有34例（27％）和38例（23％）患者在LR和LT之前接受过pCR。甲胎蛋白（AFP）<100 ng / mL和单个肿瘤是pCR的重要术前预测指标。pCR或PR≥90％的患者的OS和RFS显着改善，但LR和LT后PR≥50％的患者没有改善。在多变量分析中，PR≥90％仍然是LR和LT组OS和RFS较好的独立预测指标。结论总体而言，我们的数据清楚地表明，pCR预测肝癌根治性手术后预后良好，pCR的预测因子是AFP <100 ng / mL和单个肿瘤。