Primary Liver Cancer TACE In A General Hospital In Northern Shaanxi Province Therapeutic Effect And Prognostic Factors

BackgroundIn China,the incidence and mortality of primary liver cancer are in the forefront of malignant tumors,seriously affecting people’s lives and health.Due to the lack of typical clinical features in the early stage of primary liver cancer and the rapid tumor progression,patients with liver cancer had developed to the middle and late stage at the first visit,thus losing the opportunity for radical surgery.With the rise of vascular interventional therapy,TACE is widely used in patients with unsurgically resected liver cancer.It is the most commonly used method in non-surgical treatment of liver cancer and has achieved good clinical efficacy.However,TACE has deficiencies such as incomplete tumor necrosis and easy recurrence.In clinical practice,it can be found that the prognosis of different patients after TACE treatment varies greatly.Therefore,we need to find out the factors influencing the prognosis of TACE for liver cancer,reduce the influence of adverse factors on the prognosis of TACE,give play to the role of favorable factors,and let more liver cancer patients benefit from TACE treatment.PurposeThe survival of patients with advanced liver cancer after TACE treatment in a general hospital in northern shaanxi was analyzed to find out the factors influencing the prognosis,including 16 factors such as gender,age and changes in AFP.Factors significantly related to prognosis were screened out to provide clinical basis for judging the prognosis of liver cancer patients treated with TACE.Materials and methodsRetrospective analysis in January 2014-June 2018 in delay of establishing affiliated hospital of tumor interventional ward with conventional treatment of 108 cases of middle-late stage primary liver cancer patients,all patients by pathology or imaging,serum AFP value confirmed,through medical record browser data collection,telephone or outpatient follow-up related situation,the information collected by SPSS25.0 software for statistical analysis.Kaplan-meier method was used to calculate the median survival time and corresponding survival rate,and the survival function curve was drawn.Kaplan-meier method and log-rank test were used for univariate analysis,and Cox regression and log-rank test were used for multivariate analysis.Results1.A total of 108 cases were collected in this study.The cumulative survival rates at6,12,and 18 months were 78.1%,59.0%,and 51.4%,respectively,and the median overall survival time was 19 months.2.The factors that may affect the prognosis of liver cancer TACE include gender,age,whether there is hepatitis,child-pugh classification of liver function,Barcelona classification,etc.Since all the collected patients have hepatitis B or C,antiviral therapy and microcatheter application,these factors will not be analyzed in the future.Using Kaplan Meier method and the Log-rank test the remaining 13 factors in single factor analysis,the final was statistically significant prognostic factors have Barcelona in installment,Child-Pugh,liver function grade,preoperative with conventional transfer,has noted,vein tumor emboli and presence of periodic review,changes with conventional treatment times,AFP,tumor location(the left hepatic lobe,right hepatic lobe,lobes)eight factors.3.The above 8 factors were introduced into Cox regression model.In order to eliminate the mutual influence among various factors,stepwise regression method was adopted.At last,five factors were found to be significantly correlated with long-term prognosis(P < 0.05),namely,Barcelona stage,whether TACE had metastasis before surgery,whether TACE had regular review,TACE treatment times,AFP changes.Conclusion1.The cumulative survival rates at 6,12,and 18 months after TACE treatment of primary liver cancer in this region were 78.1%,59.0%,and 51.4%,respectively,with a median survival time of 19 months.2.Barcelona(BCLC)stage,whether there is metastasis before the first TACE treatment,whether there is regular review during the treatment,the total number of TACE treatments,and the change of AFP value are independent factors affecting theprognosis of patients with primary liver cancer after TACE treatment.3.Early staging in Barcelona,normal serum AFP before TACE or reduced after the first TACE operation,appropriate increase of TACE treatment frequency,and regular review may indicate better prognosis and longer survival time of patients with liver cancer after TACE treatment.Cancer patients have a better prognosis and longer survival time after TACE treatment.And vice versa.