| In China, primary liver cancer(hereinafter referred to as liver cancer) is ranked second only to lung cancer. Each year about 30 million people worldwide died of liver cancer, while China accounted for 55% of liver cancer deaths worldwide. Liver cancer has insidious onset and atypical early symptoms, it has progressed to an advanced stage when diagnosed, most patients lose the opportunity to completely treatment, in addition, 90% patients with liver cancer have hepatitis and/or cirrhosis, and they always have different stage of cirrhosis, resection rate less than 20% of them.For topical treatment of liver cancer treatment because of their limitations,their treatmentthoroughness,effectiveness vary.Although liver transplantation simultaneous removal and replacement of abnormal liver foci, but due to liver sources, subsequent high cost of treatment, so that only benefit a few patients, it is difficult to benefit the public. In recent years, along with targeted therapies into clinical trials for treatment of liver cancer provides a new way, but because of the uncertainty of the efficacy and significant side reactions, the scope of application was limited, in view of the complexity of the disease of liver cancer, various treatment limitations, various means comprehensive treatment of liver cancer has become the consensus. Objective:In this paper, based on reality, the existing medical information discussed on the basis of clinical commonly used method of treatment of liver cancer and prognostic factors,provide a theoretical basis for clinical treatment Methods :Clinical data of 145 cases with PLC admitted between Feb.,2012 to Feb.,2015 were retrospectively analyzed. Of the 145 patients, 22 cases were untreated, 84 received TACE, 9 received surgery alone and 30 received TACE and surgery. TACE group were treated by interventional chemoembolization, surgery group were treated by liver segment or lobe resection surgery and TACE plus surgery group were treated with the combination of the above two methods. Multivariate Cox regression analysis was used to analyze the possible influencing factors. Kaplan-Meier was used to estimate the cumulative survival rate, and Log-rank test and Breslow test were used to compare the differences among groups. Results:1. Median survival time of untreated group was 2 months;Median survival time of TACE plus surgery group and surgery alone group(19 and 17 months respectively) was significantly longer than that of TACE group(9 months respectively).2. In single TACE group,the medial survival time was significantly prolonged with the increasing of treatment times.3.In several periods observed, there were significant statistically differences in survival rate between untreated group and other groups; the group TACE and group surgery differences in the survival rate of 36 months was statistically significant(31/84vs0/9);the significant statistically difference of survival rate was observed in former 3 periods between TACE and TACE+Surgery(73/84 vs 30/30 respectively in stage 1st, the stage 2nd was 58/84 vs 27/30,stage 3rd was 41/84 vs 22/30),but the fourth observed period they were same(p=0.052);comparison of group Surgery and TACE+Surgery, there were no significantly difference in former stage, but they showed significantly difference in the last stage(0/9vs15/30).4. The factors that may affect the prognosis of PLC included viral hepatitis,maximum diameter of tumor and treatment plan. Conclusions:1.Surgery or TACE+Surgery therapy can significantly prolong the Median survival time of PLC patients, and so do the TACE, but the effect of TACE is not as well as the two former.2.Repeated TACE therapy can prolong the survival time of PLC patients, suggesting that repeated TACE therapy after comprehensive assessment of the disease3.TACE therapy and surgical treatment had no obvious difference on short-term survival rate in patients with hepatocellular carcinoma, but the long-term survival rate of surgical treatment is superior to interventional therapy.4.The factors that affect the prognosis of PLC included viral hepatitis, tumor maximum diameter and treatment plan. |
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