The Survival Analysis To53Patients With Hepatocellular Carcinoma Radical Resection Adjuvant Tace Treatment

Objective:To study the influncing of hepatocellular carcinoma radical resection adjuvant transcatheter arterial chemoembolization treatment on recurrence and survival.Methods:The clinical data of53patients with HCC radical resection adjuvant TACE treatment in the affliliated tumor hospital of Guangxi medical University from March2002to March2006were collected. As a comparison, the clinical data of64patients was collected randomly from HCC postoperative in the same period. Using the method of retrospective study,we can analysis the treatment of1,2,3,5year tumor-free survival rate and1,2,3,5year accumulate survival rate,so as to discuss the auxiliary TACE treatment after the operate of HCC has an effect of recurrent and survival. The date to end of follow-up is March31,2011,with recurrence or death as the end of the event.Results:1. After the operation,the64patients’complication rate was12.5%(8/64), of which5patients had right pleural effusion,3patients had a few amount of effusion below the diaphragm. The53patients’complication rate was9.4%(5/53),of which3patients had right pleural effusion,2patients had a few amount of effusion below the diaphragm. After the TACE treatment,there were35patients had nausea, vomiting, pain, fever and other symptoms in53patients,8patients had mild liver damage, but the symptom will relieve after symptomatic treatment. All the patients didn’t appear serious complication and death related to operation. The difference of two groups’complications rate was not statistically significant (x2=0.276,P=0.599).2. The median tumor-free survival time of the TACE treatment after operation group was31months,1.2.3.5-year tumor-free survival rate were84.9%.60.4%.39.6%.18.9%.The median tumor-free survival time of the group who was treated only by operation was22months.1、2、3、5-year tumor-free survival rate was70.3%、43.8%、21.9%、12.5%. Through the Log-Rank inspection to two group of1、2、3、5-year tumor-free survival rate,we can conclude that P<0.05,the difference had statistical significance. Taking into account of many factors that impact on the results of comparison,we established COX regression equations, obtained the optimal model. the results show that the postoperative adjuvant TACE is an independent factor of the tumor-free survival rate (P=0.026, RR=1.558)3. The median accumulate survival time of the TACE treatment after operation group was53months,1.2.3.5-year accumulate survival rate were98.1%、86.8%、69.8%、47.2%.The median accumulate survival time of the group who was treated only by operation was36months.1.2.3.5-year accumulate survival rate was87.5%、71.9%、50.0%、31.3%. Through the Log-Rank inspection to two group of1.2.3.5-year accumulate survival rate,we can conclude that P<0.05,the difference had statistical significance. Taking into account of many factors that impact on the results of comparison, we established COX regression equations, obtained the optimal model.After eliminated the influence of various factors may cause,the results show the postoperative adjuvant TACE is an independent factor of the cumulative survival rate(P=0.002, RR=1.958)Conclusion:Through the analysis to the53HCC postoperative patient, we know that HCC postoperative adjuvant TACE treatment can improve tumor-free survival rate and accumulate survival rate of patients. HCC postoperative adjuvant TACE treatment early can inhabit the tumor’s spread and metastasis for the tiny kitchen not to be founded and microvascular invasion and the tumor squeeze in the surgery. It is an independent factor on tumor-free survival rate and accumulate survival rate.