[Analysis of combinated transcatheter hepatic artery chemoembolization and factors affecting the prognosis in patients with primary hepatic carcinoma].

OBJECTIVE

To evaluate the combinated transcatheter hepatic artery chemoembolization (TACE) and analyse the factors affecting prognosis in patients with primary hepatic carcinoma.

METHODS

141 consecutive patients with primary hepatic carcinoma were treated, including 125 men and 16 women (mean age, 52 years; age range, 21 - 76 years). Combinated TACE procedures included TACE, TACE followed by surgical resection, TACE and percutaneous ethanol injection (PEI) and transcatheter hepatic artery infusion (TAI). The factors included sex, age, ALT, AFP, HBsAg, liver function (Child's system), the way of treatment, tumor size and number, serum albumin, portal cancerous thrombus, pathological type of tumors, and HBeAg. The Cox's regression analysis model was used to analyse the factors affecting the prognosis. P < 0.05 means statistically significant difference.

RESULTS

The total median survival time was 19 months and mean survival time 23.59 months. The total survival rates of 1, 2, 3, 5 years were 63.9%, 44.5%, 25.8% and 7.4%, respectively. Multivariable analysis revealed significant prognostic factors as follows: age, liver function, the way of treatment, portal cancerous thrombus and pathological types of tumors (chi2 = 45.993, P = 0.0001).

CONCLUSION

The combinated TACE procedure is safe and effective. In this study, 5 factors directly influencing the prognosis are age, liver function, portal cancerous thrombus and pathological types of tumors are risk prognostic factors, and the way of treatment is a protective factor (chi2 = 45.993, chi2 = 0.0001).