***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Hepatectomy is considered as the potentially curative treatment for hepatocellular carcinoma ( HCC ) and used in some selected Stage IIIA HCC , which include multiple tumors more than 5 cm or tumor involving a major branch of the portal or hepatic vein(s ) ( UICC TNM staging system , sixth edition ) .  Transcatheter arterial chemoembolization ( TACE ) was used in retrospective studies to improve the survival outcome of resected HCC . However , its beneficial effect on the survival outcomes of the Stage IIIA patients has not been evaluated . The present study is to evaluate if hepatectomy combining with adjuvant TACE for Stage IIIA HCC result in better long-term survival outcome when compared with hepatectomy alone . Methods From January 2001 to March 2004 , we conducted a prospect i ve r and omized trial in patients with Stage IIIA HCC ( NCT00652587 ) , recruiting 115 Stage IIIA HCC patients to undergo hepatectomy with adjuvant TACE ( HT arm ) or to undergo hepatectomy alone ( HA arm ) in our cancer center .  Survival outcomes of the two arms were analyzed . Results The demographic data were well matched between the two arms . There were no significant differences in the morbidity and in-hospital mortality between the two arms of patients . The most significant toxicities associated with adjuvant TACE were nausea/vomiting ( 54.4 % ) and transient hepatic toxicity ( elevation of aminotransferase , 52.6 % ) . Although there was no significant difference in the rate of recurrence between the two arms ( 50/57 vs. 56/58 , P = 0.094 ) , HT arm seemed to have more proportion of single lesion of recurrent HCC ( χ2 = 3.719 , P = 0.054 ) and more proportion of potential curative therapy for recurrence ( χ2 = 4.456 , P = 0.035 ) . Until the time of censor , 92 patients had died . The 1- , 3- , and 5-year overall survival rates and median overall survival for HT arm were 80.7 , 33.3 , 22.8 % and 23.0 months , respectively . The corresponding overall survival rates and median overall survival for HA arm were 56.5 , 19.4 , 17.5 % and 14.0 months , respectively . The difference was significant ( stratified log-rank test , P = 0.048 ) . The 1- , 3- , and 5-year disease-free survival rates and median disease-free survival for HT arm were 29.7 , 9.3 , 9.3 % and 6.0 months , respectively ; correspondingly , for HA arm were 14.0 , 3.5 , 1.7 % and 4.0 months , respectively ( stratified log-rank test , P = 0.004 ) . Conclusions For Stage IIIA HCC , hepatectomy with adjuvant TACE efficaciously and safely improved survival outcomes when compared with hepatectomy alone OBJECTIVE To explore the effect of postoperative adjuvant transarterial chemoembolization ( TACE ) upon early recurrence of hepatocellular carcinoma ( HCC ) patients after radical resection . METHODS Between November 2000 and December 2007 , 2591 HCC patients undergoing radical resection were retrospectively recruited . Patients undergoing resection alone  were selected as control group while those receiving post-operative adjuvant TACE  as intervention group . The patients were further stratified into tumor < or = 5 cm with low or high risk factors for residual tumor and tumor > 5 cm with low or high risk factors for residual tumor . A low risk factor for residual tumor was defined as single tumor and without microscopic tumor thrombus while a high risk factor for residual tumor was defined as 2 - 3 nodules or with the presence of microscopic tumor thrombus . The effect of adjuvant TACE upon early ( < or = 2 years ) recurrence was evaluated . RESULTS Recurrent rates of tumor < or = 5 cm with low or high risk factors for residual tumor and tumor > 5 cm with low or high risk factors for residual tumor at Month 3 post-resection were 1.34 % , 3.17 % , 5.33 % and 8.43 % in the control group versus 4.14 % ( P = 0.002 ) , 8.15 % ( P = 0.011 ) , 12.88 % ( P = 0.002 ) and 14.29 % ( P = 0.045 ) respectively in the intervention group ; recurrence rates at Month 6 post-resection were 4.63 % , 8.73 % , 11.50 % and 19.46 % in the control group versus 6.71 % ( P = 0.133 ) , 13.48 % ( P = 0.070 ) , 21.02 % ( P = 0.052 ) and 23.94 % ( P = 0.210 ) respectively in the intervention group . For patients remaining recurrence free within the first 6 months post-resection , there were no significant differences in recurrence rates at Months 9 , 12 , 18 and 24 post-operation between each intervention group and control group . CONCLUSION Postoperative adjuvant TACE has no preventive effect upon early recurrence , but may be of benefit to detect residual tumor and early recurrence Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND / AIMS Prevention of recurrence is the most important strategy to improve long-term survival after resection of hepatocellular carcinoma ( HCC ) . This comparative study aim ed to evaluate the outcome of adjuvant transarterial chemoembolization ( TACE ) after hepatectomy . METHODOLOGY From February 1996 and September 2001 , 721 consecutive patients ( adjuvant TACE treatment vs. control group ; 145 vs. 576 ) with R0 resection for HCC were analyzed . The prospect i ve data was analyzed retrospectively . RESULTS After a median follow-up of 75 months , 89 patients ( 61.4 % ) in the adjuvant TACE group and 355 patients ( 61.6 % ) in the control group had recurrent disease . There was no significant difference in the tumor recurrence rate between the 2 groups . There was significant difference in the tumor recurrence time between the 2 groups . The 1- , 3- and 5-year overall survival rates were 96.5 % , 70.0 % and 55.9 % , respectively , for the adjuvant TACE group and 80.8 % , 49.7 % and 38.8 % , respectively , for the control group . The 1- , 3- and 5-year disease-free survival rates were 79.9 % , 54.9 % and 48.4 % , respectively , for the adjuvant TACE group and 60.2 % , 39.8 % and 31.5 % , respectively , for the control group . The differences in the disease-free survival rates and the overall survival rates between the 2 groups were significant . In subgroup analysis , there was significant survival benefit in the adjuvant TACE group in the subgroup of patients with risk factors of recurrence - large tumor size , presence of satellite tumor nodules and narrow resection margin . CONCLUSIONS Adjuvant TACE improved surgical outcome in those patients with risk factors of HCC recurrence BACKGROUND Recurrence of hepatitis B-related hepatocellular carcinoma ( HCC ) after curative resection is the leading factor influencing the prognosis of the disease . Therefore , further improvement of long-term survival may depend on the prevention and treatment of the recurrent tumor . The aim of this research was to investigate the role of antiviral therapy and postoperative transcatheter arterial chemoembolization ( TACE ) in the prevention and treatment of hepatitis B-related HCC recurrence . METHODS One hundred and twenty patients who underwent curative resection of hepatitis B-related HCC between January 2005 and June 2008 at our hospital were enrolled . Patients were divided into four groups according to the post-operative adjuvant therapy they received , i.e. , control , antiviral therapy group , TACE group , and combined group . The disease-free survival ( DFS ) and the 12- , 24- , 36-month cumulative recurrence rates were studied . RESULTS There was no significant difference between isolated postoperative antiviral therapy group and control in terms of disease-free survival ( P = 0.283 ) , while it was significantly higher in the TACE group compared to control ( P = 0.019 ) . In all patients , however , viral prophylactic therapy combined with/without TACE brought a favorable result compared to those only with/without TACE ( P < 0.001 ) . Similarly , no matter combined with or without antiviral treatment , postoperative TACE prolonged DFS ( P = 0.015 ) . Naturally , a combination of viral prophylactic therapy on the baseline TACE significantly benefited patients ' postoperative DFS ( P = 0.047 ) and vice verse ( P = 0.002 ) . The 24-month cumulative recurrence rates of combined group were significantly lower than that of isolated control group and antiviral therapy ( P < 0.001 and P = 0.011 respectively ) . However , 36-month recurrence rate was significantly different in the control group compared to the TACE group and combined group ( P = 0.040 and 0.002 respectively ) ; same as the antiviral group compared to the combined group ( P = 0.034 ) . CONCLUSIONS Post-operative TACE prevents early recurrence while antiviral therapy prevents late recurrence of HCC . Combination of antiviral therapy and TACE are suggested for prevention in HCC patients with high risk of recurrence Objective : To explore the value of postoperative transarterial chemoembolization ( TACE ) and portal vein chemotherapy ( PVC ) in patients with hepatocellular carcinoma ( HCC ) in the prevention of recurrence , and to evaluate prognostic factors in a r and omized study . Method : 131 patients with HCC were r and omly divided into 3 groups : operation only ( group A , n = 45 ) ; operation plus TACE ( group B , n = 39 ) , and operation plus TACE and PVC ( group C , n = 47 ) . Disease-free survival rates as well as prognostic factors were analyzed . Results : Most of the side effects and complications related to the operation , catheters and local chemotherapy were liver decompensation ( 16.1 % ) , catheter obstruction ( 12.9 % ) , and nausea and loss of appetite ( 25.8 % ) , respectively . The disease-free survival curves were significantly different between the 3 groups as estimated by the Kaplan-Meier method ( p < 0.05 ) . Group C had a significantly higher disease-free survival rate compared to group A ( p < 0.05 ) . But no statistical differences were found between groups A and B and groups B and C ( both p > 0.05 ) . Tumor number and treatment modalities were independent prognostic factors for HCC patients ( p < 0.05 ) . Conclusion : Postoperative TACE combined with PVC may benefit the survival of patients with HCC . In specialized medical centers , aggressive methods such as TACE and PVC should be attempted on HCC patients without contraindications Vascular invasion and intrahepatic metastasis by hepatocellular carcinoma are important factors predisposing to tumor recurrence . Recurrences of this malignancy occur frequently in residual liver , and its prevention is one of the most important factors in obtaining better surgical survival .  Fifty patients who underwent hepatectomy for invasive hepatocellular carcinoma with vascular invasion and /or intrahepatic metastases were studied to evaluate the effect of adjuvant bolus hepatic arterial infusion of iodized poppyseed oil ( Lipiodol ) containing anticancer drugs in preventing recurrence and in prolonging survival . Patients were assigned to two treatment groups . Twenty-three of the fifty patients received adjuvant bolus infusion of Lipiodol containing doxorubicin and mitomycin C , whereas 27 patients received no therapy . The disease-free survival rate for the patients who received adjuvant therapy was significantly better ( p < 0.05 ) than that for those who did not when measured at 172 , 516 , 688 and 860 days after hepatectomy , and the disease-free survival curve for patients with adjuvant therapy was significantly ( p = 0.0237 ) better than that without adjuvant therapy . The cumulative survival rates and curves were not significantly different between the two groups . While adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs was effective in improving disease-free survival , the effect was not satisfactory . Further trials of adjuvant chemotherapy are required to improve the surgical survival of hepatocellular carcinoma patients From April 1990 to December 1993 , 140 patients were recruited to a r and omized study to evaluate transcatheter hepatic arterial chemoembolization ( TACE ) as an adjuvant therapy for primary liver carcinoma after hepatectomy . This study investigated the principle , techniques and results of TACE . The 
    Output:
    
Conclusion Post-operative aTACE is safe and improves overall and disease-free survival , with the greatest benefit in MVI-positive patients .