| Primary liver cancer is one of the tumor with the highest incidence in the world, China is one of the regions with a high incidence。 In recent years, the incidence of the disease is on the rise, the higher degree of malignancy, the higher mortality.Due to the biological characteristics of the primary liver cancer,many patients found it so late that they lost the opportunity of surgery. With the application of interventional therapy in the field of cancer, a variety of new technologies, minimally invasive method has become the focus of the treatment of hepatocellular carcinoma. For the inoperable advanced patients, transcatheter arterial chemoembolization (TACE) has become the preferred method for them. In 1976, wdlace first reported the TACE in the treatment of primary hepatocellular carcinoma and then transcatheter arterial chemoembolization (TACE) swept the world. In the late 1980s, the interventional radiology treatment developed rapidly in our country. At present, transcatheter arterial chemoembolization (TACE) has become the preferred method of advanced hepatocellular carcinoma (HCC), and is the effective measures before the second period of operation. TACE as a palliative surgery has many shortcomings such as not-completely tumor necrosis, easy to recurrence. How to use TACE to improve the prognosis of patients has become the most important clinical problem. Researchers have brought forward the comprehensive interventional treatment, including TACE combined with radiofrequency ablation (RFA), the second phase of the operation or cytokine activated killer (CIK) cells infusion therapy. They are all better than simple TACE treatment.ObjectiveAnalysis survival and prognostic factors of advanced patients of primary liver cancer after interventional therapy.The factors that may influence the prognosis including gender, age, the AFP, times of TACE, grade of liver function Child-Paugh, tumor thrombus of portal vein, tumor size, number, metastasis, tumor type, HBsAg and so on.Then screening independent factors related to prognostic to guide treatment, improve the clinical curative effective of patients with the treatment of TACE.Materials and methodsRetrospective analysis 102 cases of primary hepatocellular carcinoma patients that hospitalized in the Department of Hepatology, Shandong Provincial Hospital from2009.08 to 2010.12.All patients were confirmed by pathology or imaging, serum AFP. Relevant data collect through telephone follow-up combined with clinical data And all the data of the patients apply SPSS.19.0 software for statistical analysis. All survival of patients use the life table method. Univariate analysis apply KM method.The survival between differenceclinical and pathological groups use Log-Rank to test, and multivariate analysis use Cox regression.ResultSimple analysis showed that:there was significant difference between various tumor size, levels of AFP, classification of liver cancer, different treatments, times of TACE treatment,tumor metastasis,portal vein thrombosis and transferation before operation.Hower,there was no significant difference between various age, gender, the number of tumor, HbsAg. Multivariate analysis:prognosis factors that may affect the interventional treatment of liver cancer be introduced into the cox model to filter the factors that related prognosis. The results showed that:different treatments, the times of TACE, metastasis, portal vein thrombosis, liver function and transferation before operationare risk prognostic factors.ConclusionsChemotherapy and embolization treatment is an effective method in the treatment of advanced liver cancer, and it is better than conservative treatment in prolonging the survival period. However, comprehensive treatment including TACE combined with radiofrequency ablation or surgery is more effective than the simple TACE. The patients with better grade of liver function, no tumor thrombus in portal vein, more times with TACE treatments, no tumor metastasis, and lower malignant of tumor pathology have a better prognosis. |
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