Objectives: We investigated whether adjuvant hepatic arterial infusional chemotherapy (HAIC) with 5-fluorouracil (5-FU) and cisplatin reduces the recurrence of hepatocellular carcinoma (HCC) after curative resection. Methods: Between January 2006 and December 2008, 31 HCC patients received four cycles of adjuvant HAIC with 5-FU and cisplatin via port system after curative resection. During the same period, 62 patients, who did not take any adjuvant therapy, were selected as controls. Results: Tumor characteristics, such as distribution of TNM stage, pathologic differentiation, portal vein invasion, or microscopic invasion did not differ between control and adjuvant groups. During follow-up, recurrence developed in 11 adjuvant (35.5%) and 24 control patients (38.7%; p = 0.823). Tumor progression after recurrence was the cause of death in 2 adjuvant (28.6%) and 7 control patients (38.8%; p = 0.912). The 2-year recurrence rate was 9.1% in the adjuvant group and 4.2% in the control group, with the median recurrence-free survival time being 10.5 and 7.5 months, respectively (p = 0.324). The 3-year cumulative survival rate was 73.3% in the adjuvant group and 68.3% in the control group (p = 0.355). Conclusion: Adjuvant HAIC with 5-FU and cisplatin did not offer any beneficial effect on the recurrence after curative resection of HCC.

1.
Shimada M, Takenaka K, Gion T, et al: Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology 1996;111:720–726.
2.
Hsu HC, Sheu JC, Lin YH, et al: Prognostic histologic features of resected small hepatocellular carcinoma (HCC) in Taiwan, a comparison with resected large HCC. Cancer 1985;56:672–680.
3.
Ikeda K, Saitoh S, Tsubota A, et al: Risk factors for tumor recurrence and prognosis after curative resection of hepatocellular carcinoma. Cancer 1993;71:19–25.
4.
Poon RT, Fan ST, Ng IO, et al: Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer 2000;89:500–507.
5.
Sugimoto R, Okuda K, Tanaka M, et al: Metachronous multicentric occurrence of hepatocellular carcinoma after surgical treatment – clinicopathological comparison with recurrence due to metastasis. Oncol Rep 1999;6:1303–1308.
6.
Ando E, Yamashita F, Tanaka M, et al: A novel chemotherapy for advanced hepatocellular carcinoma with tumor thrombosis of the main trunk of the portal vein. Cancer 1997;79:1890–1896.
7.
Epirubicin Study Group for Hepatocellular Carcinoma: Intra-arterial administration of epirubicin in the treatment of nonresectable hepatocellular carcinoma. Cancer Chemother Pharmacol 1987;19:183–189.
8.
Itamoto T, Nakahara H, Tashiro H, et al: Hepatic arterial infusion of 5-fluorouracil and cisplatin for unresectable or recurrent hepatocellular carcinoma with tumor thrombus of the portal vein. J Surg Oncol 2002;80:143–148.
9.
Park JY, Ahn SH, Yoon YJ, et al: Repetitive short-course hepatic arterial infusional chemotherapy with high-dose 5-fluorouracil and cisplatin in patients with advanced hepatocellular carcinoma. Cancer 2007;110:129–137.
10.
Hanazaki K, Matsushita A, Nakagawa K, et al: Risk factors of long-term survival and recurrence after curative resection of hepatocellular carcinoma. Hepatogastroenterology 2005;52:552–557.
11.
Takayama T, Sekine T, Makuuchi M, et al: Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial. Lancet 2000;356:802–807.
12.
Tang ZY, Yu YQ, Zhou XD, et al: Progress and prospects in hepatocellular carcinoma surgery. Ann Chir 1998;52:58–563.
13.
Lee JG, Kang CM, Park JS, et al: The actual five-year survival rate of hepatocellular carcinoma patients after curative resection. Yonsei Med J 2006;47:105–112.
14.
Llovet JM, Burroughs A, Bruix J: Hepatocellular carcinoma. Lancet 2003;362:1907–1917.
15.
Nelson RS, de Elzalde R, Howe CD: Clinical aspects of primary carcinoma of the liver. Cancer 1996;19:533–537.
16.
Llovet JM, Ricci S, Mazzaferro V, et al: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008;359:378–390.
17.
Bruix J, Sherman M: Management of hepatocellular carcinoma. Hepatology 2005;42:1208–1236.
18.
Nagamatsu H, Hiraki M, Mizukami N, et al: Intra-arterial therapy with cisplatin suspension in lipiodol and 5-fluorouracil for hepatocellular carcinoma with portal vein tumour thrombosis. Aliment Pharmacol Ther 2010;32:543–550.
19.
Ueshima K, Kudo M, Takita M, et al: Hepatic arterial infusion chemotherapy using low-dose 5-fluorouracil and cisplatin for advanced hepatocellular carcinoma. Oncology 2010;78(suppl 1):148–153.
20.
Kim BK, Park JY, Choi HJ, et al: Long-term clinical outcomes of hepatic arterial infusion chemotherapy with cisplatin with or without 5-fluorouracil in locally advanced hepatocellular carcinoma. J Cancer Res Clin Oncol 2011;137:659–667.
21.
Izumi R, Shimizu K, Iyobe T, et al: Postoperative adjuvant hepatic arterial infusion of lipiodol containing anticancer drugs in patients with hepatocellular carcinoma. Hepatology 1994;20:295–301.
22.
Ueno S, Tanabe G, Yoshida A, et al: Postoperative prediction of and strategy for metastatic recurrent hepatocellular carcinoma according to histologic activity of hepatitis. Cancer 1999;86:248–254.
23.
Kumada T, Nakano S, Takeda I, et al: Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma. Hepatology 1997;25:87–92.
24.
Sakon M, Umeshita K, Nagano H, et al: Clinical significance of hepatic resection in hepatocellular carcinoma: analysis by disease-free survival curves. Arch Surg 2000;135:1456–1459.
25.
Kohno H, Nagasue N, Hayashi T, et al: Postoperative adjuvant chemotherapy after radical hepatic resection for hepatocellular carcinoma (HCC). Hepatogastroenterology 1996;43:1405–1409.
26.
Lai EC, Lo CM, Fan ST, et al: Postoperative adjuvant chemotherapy after curative resection of hepatocellular carcinoma: a randomized controlled trial. Arch Surg 1998;133:183–188.
27.
Kelsen D: Preoperative chemoradiotherapy for esophageal cancer. J Clin Oncol 2001;19:283–285.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.