Background and objectives The purpose of the present study was to comprehensively analyze the prognostic value of adjuvant chemotherapy (CT) in stage IV HCC patients. Methods HCC patients were recognized in the Surveillance, Epidemiology and End Results (SEER) database. The effects of adjuvant CT on HCC patients were evaluated by Kaplan–Meier curves and multivariable Cox proportional hazards analyses. Results A total of 490 HCC patients were enrolled in this study and the median follow-up time was 2.69 months (range: 0–102 months). 34.3% (168) HCC patients received adjuvant CT, of which 58.6% (287) received local destruction, 25.5% (125) were partial resection and 15.9% (78) underwent liver transplantion. Multivariate analysis showed that chemotherapy (P <0.001), surgery (P <0.001), year at diagnosis (P = 0.004), grade (P <0.001) and fibrosis score (P = 0.039) were independent factor of cancer specific survival (CSS), and that chemotherapy (P <0.001), surgery (P <0.001), year at diagnosis (P = 0.005), grade (P <0.001) were independent factor of overall survival (OS). Survival curves confirmed that patients achieved an increased OS or CSS from adjuvant CT (P <0.05). Conclusions Our results concluded that compared to surgery alone, stage IV HCC patients could profit from adjuvant chemotherapy. High quality prospective trials are necessary to further confirm our results.
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