Survival Analysis After The Integration Of Chinese And Western Medicine For BCLC Stage C Of Primary Liver Cancer:A Retrospective Study

ObjectiveAnalyze the survival and prognosis after the treatment of the integration of TCM and western medicine in the patients of BCLC C stage of Primary hepatic carcinoma. Evaluate the applicability of different sub-classification models under the integration treatment.MethodThe research was based on the retrospective study of 73 cases which were treated by the integration of TCM and western medicine in the First Affiliated Hospital of Guangzhou university of Chinese Medicine and diagnosed as BCLC stage C of primary liver cancer during the period of April 2011 to November 2014.The overall survival was measured from the time integrated treatments started until the time of death from any cause. The end of the follow-up period was either death or January 1st,2016.The survival was analyzed by the Kaplan-Meier method, and curves were compared using the log-rank test or breslow test. Several variables were assessed by the COX proportional hazard model. Different sub-classifications of BCLC C stage were also tested by the Kaplan-Meier method to explore their efficiency under the treatment of the integration of TCM and western medicine. A typical case treated by Professor Lin will be selected for the cogitations and experience.ResultsIn all cases, the median survival was 18.8 months (95%CI 15.0-22.7). Survival rates of the entire cohort at 6 months,1 years,2 years and 3 years were 82%,67%,40%,26%.The Kaplan-Meier Analysis showed that the patients with ps score 0 was better than the others (43.4months versus 17.9months, p=0.01). The patients without portal vein invasion has a better MST (8.2 months versus 23.3 months, log-rank test p=0.000). There is no significant difference between the classification of TCM syndrome types, grade of Child Pugh, numbers of tumor, ascites, metastasis of lymph nodes, distant metastasis, hepatitis B virus infection, liver cirrhosis, gender, the level of AFP. The COX’s regression model analysis shows that the status of PS-score (0 or 1-2), portal-invasion and distant metastasis were the independent predictive factors of these patients. Compared with the C2 group, the patients of group Cl which was divided by the sub-classification of Xijing Hospital has a better MST has a better MST (32.4 months versus 15.3 months, log-rank test p=0.001). A typical case treated by Professor Lin will be selected for the cogitations and experience.ConclusionThe status of PS-score and portal-invasion did make difference in the patients who received the integrated treatment of TCM and western medicine in BCLC C stage of PLC. The Sub-classification of Xijing Hospital seems to be more efficient for predicting the survival of BCLC C stage under our treatmeants. The treatmeant of TCM can release the symptoms, slow down the progression of tumor, extend the survival by congregating disease-diagnosing and syndrome-dentifying. Professor Lin was expert in treating liver cancer by the method of Jianpiquyu.