The Clinical Curative Effect Analysis Of Huge PLC Cured By Liver Resection Combined With Prophylactic TACE

Objective:(1)To investigate the medium and long term survival status of primar huge liver cancer(PLC)treated by radical hepatectomy combined with prophylactic TACE;(2)To study factors influencing survival time after resectionof PLC.Methods:(1)Retrospective ananlysis and follow up the clinical data of 93 patients with PLC treated in the people’s liberation army 302 hospitalduring the period of 2010-2012.All patients underwent radical resection and confirmed by pathology.39 cases of simple radical resection were selected as control group,54 patients of TACE after radical resection of HCCin the 4th week later were selected as the study group;The postoperative survival rate of 1,3,and 5 years were compared and analyzed between two groups by statistical methods.(2)According to the AFP level(whether more than 400 mu g/L),tumor size(whether or not more than 8cm),capsule(whether complete),whether to merge the stove and the microscopic,whether with or without portal vein tumor embolus was divided into two group: Recurrence of low-risk group and high-risk group.(3)Univariate and multivariate analyses were performed to determine the relative independent prognostic factors for patients with PLC.Result:(1)The 1,3,and 5 year survival rate of the patients in the control group was only 61.5%,25.6%,2.6%.Respectively,the 1,3,and 5 year survival rates of surgical combine TACEpatients in the study group were 75.9%,48.1%,and 29.6%.Two sets of data for the Kaplan-Meier method to get the P value of =0.036,the overall survival rate was a significant difference(P<0.05);(2)For patients with low risk of relapse: The survival rate of TACE group and non TACE group was 78.9%,52.6%,42.1% and78.6%,35.7%,7.1%.Respectively,Use the Kaplan-Meier method to get the P value is 0.098,no significant difference between the survival rates of the two groups had no significant difference.For patients with high risk of recurrence: The survival rate of TACE group and non TACE group was 74.3%,45.7%,22.9% and 52.0%,20.0%,0%,respectively,Kaplan-Meier method was used to calculate the P value is 0.01.Therefore,there were significant differences between the two groups,the survival rate was significantly different(P<0.05).(3)Univariate and multivariate analysis showed that different treatments,portal vein tumor thrombus,tumor recurrence and etals were independent risk factors that affect the prognosis of huge PLC.Conclusion:(1)In the 2 and 4months after resection of liver cancer,TACE treatment can significantly improve the overall long-term survival rate,but it is necessary to carry out TACE treatment on the premise of good recovery of liver function;(2)For patients with high risk of relapse should be treated with TACE as soon as possible,which can significantly improve the long-term survival rate.