| Object: To evaluate the longterm efficacy and the impact factors of prognostic of PHC with TACE.Methods:143 patients with PHC underwent TACE from January 2003 to August 2009 were retrospectively studied. The survival rates were calculated by the Kaplan-Meier method, the univariate analyses for the factors affecting survival: age, sex, HBsAg, Child-Pugh score, serum alpha-fetoprotein level, TNM stage, tumor diameter, node, portal vein tumor thrombosis, arteriovenous shunt, metastasis stage, the lipiodol deposition, treatment interval, treatment times, and treatment models were evaluated by the log-rank test, and the multivariate analyses were evaluated by Cox proportional hazard model while the factors were differ in the log-rank test.Results: The 1, 3, 5-year survival rate was 60%, 24% and 12%, and the median survival time was 17 months. The 1, 3, 5-year suvrial rate was differed among groups at different TNM stage. Compared with TACE alone, multimodal treatment showed more effective at different stage. Especially in patients at stage III-IV, the 1,3-year suvrial rate was differed between TACE and multimodal treatment, while the 5 year suvrial rate was not. Only 33% of 98 patients showed Child-Pugh score increase after TACE, and no significant difference was found among the 3 groups. Log-rank analysis showed high AFP level, tumor diameter, node, presence of portal vein tumor thrombosis, the lipiodol deposition, treatment interval, and therapy models were all related to prognosis; Cox proportional hazard model showed that the lipiodol deposition and presence of portal vein tumor thrombosis were independent impact factors of prognostic for unresectable PHC.Conclution: TACE is a safe and effective therapeutic modality for unresectable PHC, multimode therapy leads to better outcomes for patients with intermediate-advanced PHC.The Lipiodol deposition and presence of portal vein tumor thrombosis were independent risk factors for survival.
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