The Analysis Of Clinic Prognotic Factors Of Primary Hepatic Carcinoma

AbstractObjective To explore prognostic factors in clinicopathological factors in hepatocellular carcinoma patients undergoing hepatectomy and non-surgical therapy.Methods1. To analyze retrospectively the clinic data of118hepatocellular carcinomapatients who were treated mainly by surgical resection in the general hospital ofNingxia meical university from January2002to January2007.And it includes Surgicalresection group which has76patients and Surgical resection combined with TACE group which has42patients.Calculate survival,recurrence rates and the medial survival time using Kaplan-meier method, To analyze the possible prognostic factors in the clinical data using the univariate analysis and the Cox proportional hazard model.2. To analyze retrospectively the clinic data of261hepatocellular carcinoma patients who weretreated mainly by non-surgical resection in the general hospital of Ningxia meical university from January2002to January2007.And they were divided into1.Transcath-eter hepaticchemo-embolizaton(TACE) group(85cases);2.surgical resection after TACE group (31cases);3.3-dimensional conformal radiotherapy (3-DCRT) after TACE group(23cases);4.drugs group(122cases);Calculate survival rate and the medial survival time usingKaplan-meier method, To analyze the possible prognostic factors in the clinical data using the univariate analysis and the Cox proportional hazard model.Results1.The median survival for the patients who were treated mainly by surgical resection was25.0months, The1-,3-and5-year overall survival rates were79.7%、33.3%、18.1%, and their recurrence rates were34.6%、58.3%、73.6%, respectively. Th us,distant metastasis,UICC staging,Child-paugh classification,tumor size,finding way,thenumber of nodules and pathological type were significant prognostic factors;but the multivariate analysis showed that treatment,portal vein cancer thrombus,UICC staging andfinding way were independent factors influencing prognosis.2.The median survival forall the patients who were treated mainly by non-surgical resection was14.0months.The median survival for the patients in TACE group and surgicalresection after TACE group were32.0months and21.0months,The1-,2-and3-year overall survival rates ofTACE group and surgical resection after TACEgroup were80.0%、50.1%、30.5%and85.2%、68.5%、45.8%, respectively.The median survival for the patients in3-DCRTafter TACE group and drugs group were11.0months and7.0months, The1-,2-and3-year overall survival rates of3-DCRT after TACE group and drugs group were46.4%、6.7%、0%and25.4%、3.3%、0%, respectively. The significant difference betweenthe different treatment modelities was significant.The univariate analysis indicated thattreatment,portal vein cancer thrombus,UICC staging,Child-paugh classification,the number of nodules,HbsAg and finding way were significant prognostic factors;The multivariate analysis indicated that Child-pugh classification,finding way,treatment,portal vein cancer thrombus,UICC staging were significant prognostic factors.Conclusion1.Treatment,portal vein cancer thrombus,UICC staging and finding way were independent factors influencing prognosis in patients who were treated mainlyby surgical resection.2.Child-pugh classification,finding way,treatment,portal vein cancer thrombus,UICC staging were significant prognostic factors in patients who were treated mainly by non-surgical resection.3.Surgical resection combined with TACE significantly improves the survival rates of patient with primary liver carcinoma.4.Three times’TACE were approppriate,Surgical resection after TACE was the most effective treatment for patients who were treated mainly by non-surgical resection.The complexing ther apy could improve significantly the survival of Primary hepatic carcinoma in middle andlate period.