Analysis Of Therapeutic Effect Of The Two-stage Operation After Intervention For Hepatocellular Carcinoma (Following 50 Cases)

Objective:Based on the clinical data retrospective study of liver cancer resection after intervention.We could approach the influencing factors of therapeutic effect,which contribute to establish more reasonable clinical and effective treatment measures for doctors to improve the prognosis of patients.Methods:The 50 HCC patients who had undergone resection after in- tervention since June 1994 to October 2007 were followed retrospectively. Through statistical analysis of the relevant clinical data,We may find out the factors which could influence therapeutic effect.Results:1.46 cases of the total 50 patients were successfully followed up to October 20, 2007,the other four lost,the follow-up rate 93%.six month,one year,two year recurrence rates after two-stage liver cancer surgery were 25%,45%,65%.Our data showed that 1 year,2 year,3 year disease-free survival rates were 55%,35%,22% and 1 year,3 year,5 year survival rates were 85%,59%,36%.2.Cox-multivariate stepwise regression analysis displayed that statistically significant difference ones of 23 factors that impact recurrence of two-stage liver cancer surgery were vascular thrombosis(P<0.05, RR=5.349), the number of in- tervention (TACE)(P<0.05, RR=1.620), tumor resection size(P<0.05, RR =1.301), the interval time between intervention and surgery(P<0.05, RR =1.102). The five factors such as vascular thrombosis(P<0.05, RR=7.639), the number of intervention(TACE)(P<0.05, RR=1.960), tumor resection size (P<0.05, RR=1.549), the interval time between intervention and surgery (P<0.05, RR=1.156), the treatment of postoperative recurrence(P<0.05, RR=0.659) were statistically significant difference.Conclusion:1.The following factors that vascular thrombosis, re- section, tumor size, number of involved (TACE), the interval time between intervention and surgery were the independent risk factors of two-stage liver cancer surgery recurrence;2.The factors that influence post- operative therapeutic effect were vascular thrombosis, tumor resection size, intervention frequency(TACE)and the interval time between inter- vention and surgery;3.It is suitable that the time of preoperative interventional therapy is 1～2 and the two-stage liver cancer operation within 2～3 months after the end intervention should be implemented. The use of local radical resection had no significant effect on the total effects but could reduce the rate of postoperative liver failure.