The Efficacy And Prognostic Factors Of Hepatic Artery Embolization Chemotherapy Combined With Radiofrequency Ablation For Unresectable Liver Cancer

Objective: This study aimed to compare the efficacy and safety of radiofrequency ablation(RFA)combined with transarterial chemoembolization(TACE)for unresectable HCC with a single treatment.Methods: From June 2009 to June 2012,190 patients with unresectable HCC who underwent non-surgical treatments in our center were included in this retrospective study.According to treatment modality,these patients were divided into three groups: RFA was used as the sole first-line anticancer treatment in 61 patients(RFA group);TACE was used as the sole first-line anticancer treatment in 67 patients(TACE group).RFA followed by TACE was performed in 62 patients(combination group).Indices including complications,treatment success rate,intrahepatic progression free survival and overall survival were obtained for analysis and comparison.Results: There was no significant difference in baseline characteristics among the three groups.Treatment success was achieved in 49 patients of RFA group,43 patients of TACE group and 40 patients of combination group.No significant difference was found in 3-year intrahepatic progression free survival or 3-year overall survival among the three group.Further survival analysis was performed for the patients who achieved treatment success.We found that AFP level did not differ among three groups(P=0.4673).The 3-year intrahepatic progression free survival probability was significantly better in combination group than in TACE group(P= 0.0094;HR,0.5105;95% CI,0.3022 to 0.8625)or the RFA group(P= 0.0111;HR,0.5233;95% CI,0.3149 to 0.8697).The 3-year overall survival probability was significantly better in combination group than in TACE group(P= 0.0100;HR,0.5069;95% CI,0.2936 to 0.8752)or the RFA group(P= 0.0054;HR,0.4913;95% CI,0.2928 to 0.8246).In patients who achieved treatment success,total hospitalization cost of TACE group,RFA group and combination group was(37534.88 ± 6802.84)Chinese yuan,(62816.33 ± 9091.37)Chinese yuan and(63708.14 ± 9193.81)Chinese yuan.Therefore,the combination group had a significantly higher total hospitalization cost than the TACE group(P=0.0000).There was no significant difference in total hospitalization cost between the combination group and the RFA group(P=0.6481).All complications were controllable and no permanent adverse sequelae or procedure-related deaths were observed.Conclusion: Combination therapy of RFA and TACE was superior to TACE alone or RFA alone in improving survival for patients with unresectable hepatocellular carcinoma.Objective: This study aimed to determine the factors associated with intrahepatic progression free survival and overall survival of unresectable hepatocellular carcinoma(HCC).Methods: From June 2009 to June 2012,132 patients with unresectable HCC who underwent and finished non-surgical treatments in our center were included in this retrospective study.Indices including age,gender,main tumor size,Child-Pugh Class,number of tumors,Karnofsky performance score,background liver disease,AFP level and treatment modality were analyzed by Cox univariate and multivariate analysis to determine the factors associated with intrahepatic progression free survival and overall survival.Results: A total of 95 patients developed intrahepatic progression during the first three years after treatment initiation.The probabilities of intrahepatic progression free survival at 3 years were 28.03%.A total of 90 patients died during the first three years after treatment initiation.The probabilities of overall survival at 3 years were 31.82%.Main tumor size,number of tumors and treatment modality were demonstrated to be important factors associated with 3-year intrahepatic progression free survival and overall survival(P<0.05)by univariate and multivariate analysis.Conclusion: Main tumor size,number of tumors and treatment modality were important factors associated with intrahepatic progression free survival and overall survival.Combination therapy of transarterial chemoembolization and radiofrequency ablation,less number of tumors and smaller main tumor size indicated lower risk for intrahepatic progression and motality.