Effect Of Preoperative Adjuvant Transcatheter Hepatic Arterial Chemoembolization On Prognosis Of Huge Hepatocellular Carcinoma

Aim:Although there is great progress in the early diagnosis of liver cancer now,the majority of patients in the outpatient department are diagnosed as large or huge liver cancer in its diameter which is in the middle-late period because of the hidden disease.Surgical resection is still the preferred treatment for the huge hepatocellular carcinoma when its surgical contraindications are ruled out.But after the surgical resection the recurrence rate is high and the prognosis is unsatisfactory,so we need to research how to improve the prognosis of the huge hepatocellular carcinoma patients.The study retrospectively analyzed the role of the preoperative adjuvant TACE and the only surgical resection,evaluated te effect of preoperative adjuvant TACE on prognosis of huge hepatocellular carcinoma.Methods:Retrospective study of 31 huge hepatocellular carcinoma who were diagnosed histopathologically as hepatocellular carcinoma in Xiamen University affiliated Zhongshan Hospital from January 2010 to March 2015 was done.Results:By the clinical observation and follow-up,?The transformation in tumor:in the group of the preoperative adjuvant TACE combined secondary operation(n=10),the results shows that 80% patients showed reduction in tumor size,and among them,60% showed the tumor size was less than 10 cm in diameter following the preoperative adjuvant TACE,20% patients showed the progression in tumor size,none showed the same size or new intrahepatic extrahepatic lesions.The postoperative pathology showed,in the group of the preoperative adjuvant TACE combined secondary operation tumor necrosis in 80% patients and total necrosis in 20% patients.Likewise in the group of only operation only 4.8% patients showed tumor necrosis,none showed the total necrosis.There is statistical difference amongthe two groups(P<0.05).?The perioperative period:the liver function in the preoperative period,the first in postoperative period,the third in postoperative period,the sixth in postoperative period have no statistica difference compared in the two groups(P>0.05). None showed futher deterioration in liver function in the two groups.The surgical time consuming,the bleeding volume in the operation and the volume of drainage from the abdominal cavity in the postoperative period have no statistica difference compared in the two groups(P>0.05).?The prognosis:there is statistica difference compared in the survival curves in the two groups.The preoperative adjuvant TACE which is the main way to treat huge HCC may increase the overall postoperative survival of huge HCC.Conclusions:The preoperative adjuvant TACE for huge hepatocellular carcinoma will narrow the volume of the tumor,increase the opportunity for sugical resection,may increase the overall postoperative survival of huge HCC patients,won’t lead to significant liver function damage or increase the difficulty of the surgical resection,won’t delay the recovery.