Analysis Of The Recurrence Risk Factors For Recurrence After HIFU Combined With TAE For Primary Hepatic Carcinoma

Objective:Our aim was to investigate the risk factors for recurrence after HIFU combined with TAE for primary hepatic carcinoma, to provide reference basis for improving the clinical treatment plan of HIFU ablation for primary hepatic carcinoma.Methods: Retrospective analysis of 46 cases of Primary liver cancer patients in the second affiliated hospital of Chongqing Medical University, from October, 2009 to August, 2015, according to recurrence during follow-up. All patients’ diagnosis with primary hepatic carcinoma would perform TAE to close tumor vascular bed and reduce tumor blood supply. After 1-2 weeks, all patients performed follow-up HIFU ablation via JC type focused ultrasound tumor therapeutic system designed by Chongqing HIFU Technology Co, Ltd. Chongqing China. AFP, enhanced CT/MRI would be checked on 2 weeks after HIFU treatment, and follow-up record would be established at the same time.The variables of age, HBs Ag,cirrhosis,AFP, tumor number, tumor size, tumor capsule,tumor ablation volume were thought to relate to PLC recurrence. Use the IBM SPSS Statistics 19 software for data processing, Kaplan-Meier method, Log-Rank test, and COX-regression method to analyze the risk factors for affecting the tumor recurrence after TAE combined with HIFU for primary hepatic carcinoma treatment.Results: 1. We investigate 46 patients in this study, including 41 male and 5 female; their ages range from 31 to 76 years old, and the average age is 50.37±11.80,there are 24 people who are over 50 years old and 22 people who are under 50 years old; their tumor size ranges from 1.4cm to 9.5 cm and the average size is 4.33 ±2.25 cm, there are 18 people whose tumor size is more than 4cm while 28 people less than 4cm.Before the treatment,the number of the patients whose AFP are more than 20ng/ml is 24, while the number of patients whose AFP is less than 20ng/ml is 22; 42 people test positive for HBsAg and 4 people negative; 29 patients suffer cirrhosis of the liver and 17 patients do not; 37 patients carry Single tumor while 9 multiple tumor; 22 people have tumors with the whole capsules and 24 people have tumors with no or partial capsules.2. After 2 weeks’ HIFU treatment, the AFP level of patients decline from to 219±364.84ng/ml, statistically significant(P < 0.05);As for tumor ablation: 31 people experience a complete ablation, 15 partial melting, and no patient have failed; we began our follow-up after HIFU had finished. the shortest follow-up time is one month and the longest is 53 month, the average month is 13.9±12.4 months, the medium follow-up time is 11 months,. during which the number of patients who recurred metastasis were 42/46(91.3%).according to univariate analysis, three factors take responsibility for the recurrence, they are AFP(P=0.000)、tumor size(P=0.007)and tumor ablation(P=0.005).tumor size(P=0.045) and tumor ablation(P=0.000) are two main factors which Affect the combined treatment of HIFU and TAE for primary hepatic carcinoma.Conclusion:1. Through the single factor analysis, AFP, tumor size and tumor ablation volume are independent related factors affecting of hepatic carcinoma recurrence after HIFU combined with TAE for primary liver cancer.2. For part of the melt PHC in clinical, we may reduce the recurrence risk through the second HIFU combined with other treatment to reduce the tumor load.