| Background and objectives:As a very common malignant tumor in the world,primary liver cancer has a high morbidity and mortality.The distribution of liver cancer has geographical and gender differences.The total number of patients in Asia is higher than that in Europe and America,the number of male patients was higher than that of female patients.China accounts for half of the total number of cases in the world,so China is known as a major liver cancer country.Liver cancer is the fourth most common malignant tumor in my country.Lung cancer is the leading cause of cancer death in China,while liver cancer is the second.The prognosis of liver cancer is poor,and there are three types of liver cancer because of the different sources of tumor cells.The biological behavior of these three types of liver cancer is different.Among them,hepatocellular carcinoma(HCC)is the most studied and the largest one,accounting for75%-85% of the total number of liver cancer patients,the liver cancer in this study refers only to hepatocellular carcinoma.There are various treatment methods for liver cancer.Because of the characteristics of liver cancer and the patient’s own health status,fewer patients can be surgically treated in the early stage,and the surgical trauma is relatively large.With the advancement of science and technology and the development of minimally invasive concepts,transarterial chemoembolization(TACE),microwave ablation(MWA),radio frequency ablation(RFA)and other treatments have become more and more widely used in clinical practice.Among them,microwave ablation has developed rapidly.However,various treatment methods have the possibility of disease recurrence.This article mainly discusses the factors that affect the survival and prognosis of patients with liver cancer after microwave ablation in our hospital,hoping to enable the patients to achieve longer survival.Nomogram: Nomogram is a statistical tool for quantifying risk through intuitive charts,which can provide individualized prognostic information according to the prognostic factors of the disease,making the results visualized,intuitive,and easier to understand.It is a practical method commonly used in clinical practice.Because microwave ablation technology is a relatively new technology,it is still in the process of development and has not fully covered all cities.Therefore,there are few established models for predicting the recurrence of liver cancer after microwave ablation at home and abroad.This paper mainly analyzes the prognostic factors after microwave ablation of liver cancer in Yan’an University Affiliated Hospital,and establishes a recurrence prediction model after microwave ablation on this basis.Method:A total of 101 patients who underwent microwave ablation of liver cancer in the Affiliated Hospital of Yan’an University from 2014.01.01 to 2019.01.31 were selected,of which 8 patients were lost to follow-up,and 93 patients were finally included.All patients were diagnosed with hepatocellular carcinoma by imaging or pathological examination according to the guidelines of diagnosis and treatment.The basic clinical data related to the patients were collected,and SPSS 24.0 software was used for data-related integration and analysis,and the Kaplan-Meier method was used to calculate the patients’ median disease-free survival time,median overall survival time,and their respective survival rates.At the same time,the survival curve of the patients was drawn;the Log-rank test was used to conduct univariate analysis on possible prognostic factors,and the relevant prognostic factors with statistical significance were then used for the final multivariate analysis using the COX proportional hazard model.p<0.05 was regarded as the difference with statistical significance.Based on the results of the COX model analysis,the rms package and the survival function in R 4.0.3 software were used to construct a nomogram model of predicting postoperative recurrence of liver cancer patients,and the effect of the model was evaluated by Bootstrap method and graphic calibration method.Result:1.all patients did not experience life-threatening complications such as liver failure,gastrointestinal perforation,and bleeding after microwave ablation.Some patients developed clinical symptoms such as fever,pain in the operation area,ascites,and digestive tract reactions after operation,and they improved after symptomatic treatment.2.The median tumor-free survival time of HCC patients after MWA was 17 months,and the median overall survival time was 42 months.The cumulative tumor-free survival rates at 1,2,and 3 years after surgery were 59.9%,36.4%,and 27.3%;the overall survival rates at 1,2,and 3 years were 86.9%,66.1%,and 57.7%.3.The results of multivariate analysis showed that tumor BCLC stage,antiviral therapy,diabetes mellitus and AFP were independent factors affecting tumor-free survival of patients with liver cancer after MWA(all p<0.05);antiviral therapy,diabetes mellitus,AFP,tumor size,liver cirrhosis were independent factors affecting the overall survival of patients with liver cancer after MWA(all p<0.05).4.Antiviral therapy is a protective factor for prognosis.5.The established nomogram model for the recurrence of liver cancer patients after MWA has good predictive ability.Conclusion:Microwave ablation,as one of the treatment methods for the treatment of primary liver cancer,has the advantages of economy,safety,and effectiveness for patients,and most patients can obtain certain benefits from the treatment of microwave ablation.Microwave ablation has the advantages of less complications,shortened hospital stay,economy,simplicity and so on,but there is still the possibility of tumor recurrence.When the tumor recurs,the patient can choose microwave ablation again for treatment,which still has a certain curative effect.The analysis of the relevant factors affecting the tumor-free survival of patients with liver cancer after MWA showed that there were 4 independent influencing factors,while the analysis of the relevant factors of the postoperative overall survival of patients showed that 5 were independent influencing factors,and the results of the two were different.But there are innumerable connections between them.Among the factors that can affect the prognosis of patients with liver cancer after MWA,antiviral therapy is a protective factor for prognosis.The nomogram makes the results of research and analysis more intuitive,and has a certain reference value for clinical medical workers. |
PDF Full Text Request