Degree Of Tumor Necrosis After Preoperative TACE Will Effect HCC Patients' Prognosis

Objective:To investigate weather the degree of tumor necrosis after Preoperative TACE will effect the prognosis of hepatocellular carcinoma(HCC)patients.Method: Retrospectively analyzed 34 HCC patients who chose TACE as the first therapy before surgery.All the patients received at least one TACE,and than received surgery.The patients were assigned into two groups according to their degree of necrosis reported by pathology:completely necrosis group and incom pletely necrosis group.The general data are compared with the independent sam plest test.The two end points of the study were overall survival(OS)and disease-free survival(DFS).OS and RFS were estimated by the Kaplan-Meier method and compared with the Log-rank test.Predictors of completely necrosis were identified using a regression logistic model.Results: The mean age in completely necrosis group is 53.58 and 51.54 in incompletely necrosis group.In the completely necrosis group HBV rate is 100%,while in the incompletely necrosis group there are 19 HCC patients who got HBV.All the patients are Child-Pugh A level or Blevel.By analysis the CT and MRI we found that in the completely necrosis group only one patient got portal vein embolization(PVE)while in the complete necrosis group there are four patients.The mean time between last TACE to surgery is 202.6 days and114.5 days in the incompletely necrosis group.In the completely necrosis group only one patient is stage III according the TNM stage while in incompletely necrosis group there are six patients.The mean tumor diameter in completely necrosis group is 3.35 cm,while in incompletely necrosis group the mean diameter is 4.06 cm.In incompletely necrosis group 19 patients' tumor are in the right liver.The mean blood platelet is 145.85*10^9/L and 150.98*10^9/L between the two groups.The mean prothrombin time(PT)is 14.11 s and 13.41 s respectiv ely.The mean total bilirubin(TBIL)are 17.05umol/L in completely necrosis gro up and 17.01umol/L In incompletely necrosis group.All the difference among th ese general data above are not significant.The mean disease-free survival time is 35.43 months in completely necrosis group and 19.78 months in incompletely necrosis group,the difference is significant(p=0.009).The difference of overall survival is not significant in two groups.Regression logistic model indicates that the number of preoperative TACE,the tumor number and the tumor response are not predictors of tumor completely necrosis.Conclusion: The patients who got complete necrosis after Preoperative TACE will get a better mean disease-free survival time,but the difference of mean overall survival time is not significant.No predictors of tumor completely necro sis were found.