Comparative Study Of Correlative Factor In The Patients With HCC Who Were Survived More Then 5 Years After Treated By TACE

Part I Observation of the image of CT and DSA in the patients with HCC who were survived more then 5 years after treated by TACEObjective: To observe the CT findings and the image of DSA in the patients with PLC who were survived more than 5 years after treated by TACE .Materials and Methods : 104 patients of PLC (primary liver cancer) who were survived more than 5 years after treated by TACE were collected as a trial group. The age were 24-80 years old when the first TACE was done, average is 56 years old. Male was 93 and female was 11. There were 65 cases diagnosed as hepatocellular carcinoma, 2 cases diagnosed as cholangiocarcinoma, 2 cases diagnosed as cholangiohepatocellular carcinoma by the pathology. Others diagnosed as hepatocellular carcinoma by the clinical diagnosis. Another 52 cases of PLC who were survived less than 1 year after treated by TACE were collected as a contrast group. The age were 17-72 years old when the first TACE was done, average is 51 years old. Male was 45 and female was 7. There were 14 cases diagnosed as hepatocellular carcinoma by the pathology. Others diagnosed as hepatocellular carcinoma by the clinical diagnosis. The main therapy was TACE plus PEI, RFA, radiotherapy and so on in the two groups. The CT findings and the image of DSA were be analysed.Results: In the trial group, the longest survived time were more than 15 years and the patient still lived well so far. 59 cases were recurrent hepatocellular carcinoma after surgery. 14 cases were get second surgery, 6 cases got second phase surgery in the period of interventional radiology. The number of the TACE is 4-18 times. The period time of the two TACE is between 6 weeks to 4 years. The longest one from the latest TACE to survived time is 8 years. The largest diameter of the single tumor is 15 cm. The cumulated total diameter of the multiple tumors is 16 cm. All tumors were abundant with blood supply. There was no obvious A-V short in the tumor. The blood supply of the tumor is single branch in 83 cases, multiple branches in 21 cases when the first TACE was done. But in the end of the TACE the blood supply of the tumor is single branch in 57 cases, multiple ones in 47 cases. All the cases had the period that the tumor was full filled with lipiodol. 7 cases showed there was atrophy in the section of the liver where the tumor located. 8 cases biloma occurs. In the contrast group, the longest survived time was 1 year. 13 cases were recurrent hepatocellular carcinoma after surgery. No case got second phase surgery. The number of the TACE is 1-6 times. The period time of the two TACE was between 1 to 3 months. The largest diameter of the single tumor is 25 cm. There was obvious A-V short in the 31 cases, portal vein embolism in the 25 cases. The blood supply of the tumor is single branch in 39 cases, multiple ones in 13 cases when the first TACE was done. But in the end of the TACE the blood supply of the tumor is single branch in 35 cases, the multiple one in 17cases. Only 3 cases had the period that the tumor was full filled with lipiodol on the CT scan view. There were no cases showed atrophy in the section of the liver and no biloma occurs.Conclusion: The characteristic of the CT findings and the DSA images in the patients with PLC who were survived more than 5 years after treated by TACE are: smaller tumor, no A-V short, no embolism in the vein, full filled of lipiodol in the tumor. Some cases got atrophy in the section of the liver where the tumor located. Some cases biloma occurs.Part II Observation study of clinical correlative factor in the patients with HCC who were survived more then 5 years after treated by TACEObjective: To observe the clinical correlative factor in the patients ill with HCC who were survived more then 5 years after treated by TACE.Materials and Methods : 62 patients of PLC (primary liver cancer) who were survived more than 5 years after treated by TACE were collected as a trial group. The age were 24-80 years old when the first TACE was done, average is 58 years old. Male was 53 and female was 9. There were 39 cases diagnosed by the pathology. Others diagnosed by the clinical. There were varies cirrohis in all cases before first TACE. The liver function was Class A Child-pugh in 45 cases. Class B in 17 cases. No class C patient in this group. There was no metastasis tumor in the other part of the body before the first time of the TACE. Another 52 cases of PLC who were survived less than 1 year after treated by TACE were collected as a contrast group. The age were 17-72 years old when the first TACE was done, average is 51 years old. Male was 45 and female was 7. There were 14 cases diagnosed as hepatocellular carcinoma by the pathology. Others diagnosed as hepatocellular carcinoma by the clinical diagnosis. There were varies cirrohis in all cases before first TACE. The liver function was Child-pugh class A in the 25 cases, Child-pugh class B in the 27 cases. No class C patients, too. There was no metastasis tumor in the other part of the body before the first time of the TACE. 24 cases belong to I stage, 26 cases belong to IIa stage and 12 cases belong to IIb stage in the trial group. 27 cases belong to IIb stage, 25cases belong to III stage in the contrast group. The main therapy was TACE plus PEI, RFA, radiotherapy and so on in the two groups. The liver function, clinical stage of the tumor, the time number and the separate time of the TACE, the dose of the lopiodol and so on were analysed.Results: In the trial group, 26 cases got survived more than 5 years and 36 patients got survived more than 6 years. In the contrast group, the longest survived time was 1 year. There was obvious difference between 2 groups in the clinical stage (P<0.05). Almost 80% cases were II stage in the trail group. Almost 70% cases were III stage in the contrast group. AFP positive cases turns to negative about 34/38 in the trail group, only 8/34 cases turns to negative in contrast group. In the trail group, the number of the TACE is 4-18 times. The period time of the two TACE is between 6 weeks to 4 years. The longest one from the latest TACE to survived time is 8 years. The largest diameter of the single tumor is 15 cm. The cumulated total diameter of the multiple tumors is 16 cm. All tumors were abundant with blood supply. There was no obvious A-V short in the tumor. While in the contrast group, the number of the TACE is 1-6 times. The period time of the two TACE was between 1 to 3 months. The largest diameter of the single tumor is 25 cm. There was obvious A-V short in the 31 cases, portal vein embolism in the 25 cases. In the trail group, there was 45.2% cases got recover hepatocellular carcinoma in the hepatic lobe and 33.9% cases got metastasis tumor in the other organ of the body. Metastasis tumor almost occurs on the 3 years later after first TACE. While in the contrast group, 10 cases (19.2%, 10/52) got metastasis tumor in the lung.Conclusion: The characteristic of the clinical correlative factor in the patients with PLC who were survived more than 5 years after treated by TACE are: smaller tumor,early clinical stage of the tumour, liver function in Class A or Class B, AFP positive canturns to negative and kept a long period of the time. The protection of the liverfunction was very important while the TACE procedure were be done.