Analysis On Survival And Prognostic Factors In TACE In Treatment For Terminal-stage Liver Cancer

Objective:Primary liver cancer is one of common malignant tumors and its fatality rate is the second highest following lung cancer. The early stage of primary liver cancer is often neglected and difficult to be diagnosed because of the lack of clinic symptoms. Most patients are diagnosed in mid-term and terminal stage, and cases which treated with surgery operation are not commonly found. Transcatheter hepatic arterial chemoembolization is the main treatment for terminal-stage liver cancer.In recent years, normalization of diagnosis and treatment for liver cancer is more and more widely concerned.The study on TACE survival and prognostic factors has provided important references for making individualized treatment program. Nowadays, experts generally consider that a variety of factors are related to the survival and prognostic factors in TACE in treatment for terminal-stage liver cancer. The study mainly analyzes clinic parameters from terminal-stage liver cancer(gender, age, medical history of cirrhosis, medical history of hepatitis, the past liver resection 、 the past radiofrequency ablation 、arteriovenous fistula、BCLC staging、portal vein thrombosis、distant metastasis、ECOG score、Child—Pugh classification、ascites、ALT、AST、TBIL、ALB、PT、INR、AFP、target lesion number)and successive treatment in order to explore related factors which influence the survival and prognostic factors in TACE in treatment for terminal-stage liver cancer and set appropriate treatment program accordingly.Methods:Cases are randomly selected from 92 TACE in treatment for terminal-stage liver cancer patients who were hospitalized in department of Interventional Radiology of Affiliated Provincial Hospital of Anhui Medical University from July 2009 to June 2013.The clinical data of these patients are carefully read and a database of these patients is set and improved in order to carry out the study on survival and prognostic factors in TACE in treatment for terminal-stage liver cancer.Statistics are analyzed by SPSS 17.0 and life table is applied to calculate the one-year and two-year survival rate of these patients and the median survival time. Kaplan-Meier and log-rank tests are used to do analysis on survival and prognostic single factor, and the multivariate analysis on Cox’s proportional hazard regression model was conducted.P < 0.05 was considered statistically significant.Results:1.There are totally 92 patients involved in the study in which there are 78 male patients and 14 female patients and their ages range from 21 to 79. Bimodal age distribution shape,Peak located 40-50、60-70 segment.The average age is 54.6±12.4,and neutral position age is 56.2.The half-year, one-year, two-year and three-year survival rate of these patients are 68%, 47%, 19% and 4% respectively and the neutral position time is 12 months.3.The result of single factor analysis shows that gender, age, medical history of cirrhosis, medical history of hepatitis, the past liver resection、the past radiofrequency ablation、BCLC staging、portal vein thrombosis、distant metastasis、Child—Pugh classification、ascites、TBIL、ALB、PT、AFP、target lesion number and successive treatment is not related to prognostic factors in TACE in treatment for terminal-stage liver cancer(P>0.05),Arteriovenous fistula、ECOG score、ALT、AST、INR is closed related to survival and prognostic factors in TACE in treatment for terminal-stage liver cancer,statistically significant(P<0.05).4.The result of multi-factor analysis shows that the existence of medical history of cirrhosis and INR number are independent factors which influence the effectiveness of the TACE treatment for terminal-stage liver cancer(P<0.05),the past radiofrequency ablation、arteriovenous fistula、ALT、AST、target lesion number and successive treatment(P all>0.05).Conclusion:1.Arteriovenous fistula、ECOG score、ALT、AST、INR are closely related to prognostic factors in TACE in treatment for terminal-stage liver cancer,with a statistically significant(P<0.05)。2.The existence of medical history of cirrhosis and INR number are independent factors which can influence the survival and prognostic factors in TACE in treatment for terminal-stage liver cancer,Clinical should be closely pay attention to the two factors and apply appropriate combined treatment in order to achieve better treatment effect.