Clinical Study On TACE Treatment And Prognostic Factors Of Primary Liver Cancer

Background Primary liver cancer(PLC)is a malignant tumor derived from liver epithelial cells,which is divided into hepatocellular carcinoma(HCC),cholangiocarcinoma(ICC)and mixed liver cancer according to pathological types,among which hepatocellular carcinoma accounts for 85%-90% of primary liver cancer patients in China.At present,the treatment of liver cancer is mainly divided into surgical treatment and non-surgical treatment.The surgical treatment includes hepatectomy and liver transplantation.The non-surgical treatment includes:(1)Interventional treatment,including hepatic arterial chemoembolization(TACE)and hepatic arterial perfusion chemotherapy(HAIC);(2)Ablation therapy: including radiofrequency ablation(RFA),microwave ablation(MWA)and percutaneous alcohol injection ablation(PEI);(3)Systemic therapy: including targeted drug therapy,immunotherapy,chemotherapy and traditional Chinese medicine therapy;(4)Radiotherapy,etc.TACE is the preferred treatment for patients with advanced primary liver cancer that cannot be resected surgically.However,the single TACE treatment has its own limitations,and the clinical treatment of liver cancer is usually combined with different programs.In addition,in the treatment of liver cancer,it was found that even if the same treatment regimen was used,there were significant differences in the prognosis of different patients,suggesting that the prognosis of liver cancer may be affected by a variety of factors.Objective To investigate the factors influencing the prognosis and treatment of TACE in patients with primary liver cancer.The aim is to provide some evidence-based medical evidence for the selection of treatment and prognosis evaluation of primary liver cancer in clinical work.Methods This study was a retrospective study.The main subjects were newly diagnosed patients with primary liver cancer in Gezhouba Central Hospital and Renhe Hospital of China Three Gorges University from January 2017 to October 2022.Gender,age,AFP level,total bilirubin(TBIL)level,ALT level,AST level,viral hepatitis,Child-pugh grade of liver function,tumor morphology,Barcelona clinical stage of liver cancer(BCLC),distant metastasis,portal cancer thrombin,liver cancer thrombin,and liver cancer were recorded for each patient.Liver cirrhosis,treatment methods and survival time were then divided into three groups according to different treatment methods: conservative treatment group,TACE combined treatment group and simple TACE treatment group.Finally,SPSS26.0 software was used for statistical analysis,and Kaplan-Meier method was used for survival analysis.Comparison of survival time differences between groups was tested using Log-Rank,and Cox proportional risk model was used for multivariate analysis.P < 0.05 was considered statistically significant.Results(1)According to inclusion and exclusion criteria,a total of 186 subjects were included in this study.All subjects were divided into three groups according to different treatment methods: conservative treatment group,TACE comprehensive treatment group and TACE simple treatment group.Firstly,the correlation between the three treatment groups and various factors was compared.It was found that there were no statistical differences in gender,viral hepatitis,cirrhosis,AFP value and TBIL value among the three groups(P > 0.05),while there were statistical differences in age,tumor morphology,BCLC stage,ALT value,AST value,Child-Pugh grade of liver function,distant metastasis and portal cancer embolus among the three groups(P < 0.05).(2)Compared the survival rates of the three groups,the 6-month survival rates of the conservative treatment group,the TACE combined treatment group and the TACE single treatment group were 1.7%,50.0% and 21.4%,respectively.The 6-month survival rates of the conservative treatment group were the lowest,the TACE combined treatment group was the highest,followed by the TACE single treatment group.The 60-month survival rates were0.0%,6.9% and 0.0%,respectively,and the difference was statistically significant(P < 0.001)in the TACE group than in the conservative group and the TACE group alone.(3)A single factor analysis was conducted on the possible prognostic factors of TACE treatment for primary liver cancer,and it was found that tumor morphology,treatment mode,BCLC stage,viral hepatitis,AFP,ALT,AST,Child-Pugh grade,distant metastasis and portal vein cancer embolus were the prognostic factors of TACE treatment for primary liver cancer.(4)The above 10 factors with statistical differences were further incorporated into Cox proportional risk model for multivariate analysis,and it was found that tumor morphology,treatment style,BCLC stage and AST were independent influencing factors for survival and prognosis of primary liver cancer treated with TACE.Conclusion(1)TACE combined therapy and TACE alone can significantly improve the prognosis of liver cancer patients compared with conservative therapy,and TACE combined therapy is the best.(2)Treatment style,tumor morphology,BCLC stage,viral hepatitis,AFP,ALT,AST,Child-Pugh grade,distant metastasis,and portal cancer embolus are factors influencing the survival and prognosis of primary liver cancer treated with TACE.(3)Treatment style,tumor morphology,BCLC stage and AST are independent factors influencing survival and prognosis of primary liver cancer treated with TACE.