Clinical Research Of Preoperative Transarterial Chemoembolization In Treatment For Hepatocellular Carcinoma

Objective The objective of this study was to investigate influence of preoperative transcatheter arterial chemoembolization(TACE) on surgery and prognosis in patients with hepatocellular carcinoma(HCC), and provide a reference for clinical.Methods Review the medical record of 148 patients with hepatocellular carcinoma underwent hepatectomy and confirmed as HCC from January 2004 to December 2012 in our hospital. Patients were divide into 2 groups:preoperative TACE group(n=49) and one-stage operation group (n=99). Univariate analysis and multivariate analysis were performed using statistical software (SPSS 19.0 for Windows) to identify independent prognostic factors.Results the median survival of the 2 groups were 37 and 39 months in preoperative TACE group and one-stage operation group, respectively. The 1-,3-,5-year cumulative survival rates of preoperative TACE group were 93.8%,50.3%,35.9%,one-stage operation group; 87.4%,56.3%,43.7%. The 1-,3-,5-year disease-free survival rates of preoperative TACE group were 91.7%,44.4%,23.8%,one-stage operation group; 78.4%,43.9%,26.5%. There was no statistic difference in the two group (p> 0.05). There were not significant difference in the average operation time, blood loss, postoperative complications and postoperative liver function in the two groups.The average time of clamping porta hepatis was longer and adhesions were more serious in TACE group.The average tumor size was significant diminution after TACE in TACE group and preoperative TACE significantly increase the risk of pulmonary metastasis.Conclusion(1)Preoperative TACE can obviously reduce the tumor size but don’t significant influence the postoperative liver function.(2) Preoperative TACE increase the risk of pulmonary metastasis,clamping porta hepatis time and adhesions.But it don’t increase average operation time, blood loss and postoperative complications(3) Preoperative TACE did not increase the survival rate.(4) Preoperative TACE did not reduce the risk of recurrence.(5) The resectable HCC patients should be surgical excision, But for those patients with larger tumors can not be surgically removed, we can try preoperative TACE therapy to shrink the tumor before surgical resection.