Hepatocellular Carcinoma Clinical Trial
Official title:
A Randomized Controlled Study on the Effect of Intraoperative Controlled Release 5-Fluorouracil Therapy on Anti-tumor Recurrence in Hepatocellular Carcinoma Patients With High Risk of Microvascular Invasion Presence
The aim of this study is to confirmed the role of intraoperative controlled release 5-Fluorouracil therapy in the prevention of recurrence after surgery for HCC patients with high risk of preoperative prediction of microvascular invasion.
Surgical resection is the major curative treatment for patients with hepatocellular
carcinoma (HCC). However, the postoperative 5-year recurrence rate after surgical resection
was significantly high, which has been reported to 40%-70%.
Recurrence after surgery is the main factor affecting the efficacy of management of
hepatocellular carcinoma, however, there are few methods for the prevention of recurrence
and no standard treatment for recurrent HCC following curative-intent initial surgery has
been established so far. The effective prevention of recurrence is the key to improve the
management of HCC.
Previous studies showed the prevalence of microvascular invasion (MVI) in one of the
critical and negative prognostic factors for HCC patients after partial hepatectomy or liver
transplantation. For the early stage HCC patients, preoperative prediction of MVI is helpful
to identify the appropriate object of anti-recurrence treatment before or after operation.
Our another previous study established a nomogram for MVI prediction of early HCC patients,
which can preoperative efficiently predict the occurrence of MVI within Milan criteria, has
been published online in JAMA surgery. On the other hand, there are only few studies
reported the use of controlled release 5-Fluorouracil in the treatment of digestive tract
tumors.
The action time of the controlled release 5-Fluorouracil particles is more than 15 days, the
diffusion radius is 4-6cm. In theory, during the operation, the drug can be given to any
location that may have tumor residues, timely and conveniently, and has a long time to
maintain a high drug concentration, which is conducive to kill small metastatic foci caused
by MVI. However, to our best knowledge, there is no evidence of high levels of
evidence-based medical evidence to confirm the value of controlled release 5-Fluorouracil in
the prevention of HCC recurrence.
In view of this, we aim to implement a randomized controlled study to confirmed the role of
intraoperative controlled release 5-Fluorouracil therapy in the prevention of recurrence
after surgery for HCC patients with high risk of preoperative prediction of microvascular
invasion.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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