MWA Combined TACE On The Treatment Of Small And Moderate Premary Hepatic Carcinoma

Objective To analyze the effectiveness and necessity of Percutaneous microwave coagulation therapy(PMCT) combined with Transcatheter arterial chemoembolization(TACE) for the treatment of small and moderate Premary hepatic carcinoma(PHC).Method The clinical data of 54 small and moderate PHC patients who had received PMCT(group A, 23 cases) alone or in combination with TACE(group B, 31 cases) were retrospectively analyzed to compare the general data before operation, the change of liver function after treatment, average stay, postoperative complications, short-term effects and statistic its 1-year, 2-year survival rate, local tumor progression rate, intrahepatic distant recurrence rate and disease-free survival rate.Result There was no significant difference in age, sex ratio, height, weight, the diameter of tumor, hepatitis background, liver function Child-Pugh grade and AFP. Transaminase of group A and group B increased one day after treatment, and there was significant difference of the two group(P<0.05), TB had no significant difference between before and after treatment. There were no difference before treatment in liver function, one day after treatment group A: ALT: 85.1±40.8(U/L), AST: 78.4±36.6(U/L) and group B ALT: 107.1±58.9(U/L), AST: 93.8±49.5(U/L), there was significant difference of the two group(P<0.05), TB had no difference. The average stay of group B [(16.2±8.1) days] was longer than that of group A [(9.9±4.5) days]. Postoperative complications in the two group had no significant difference. The complete remission rate(CR) and partial remission rate(PR) of group A were 91.30%(21/23), 8.70%(2/23) respectively, those of group B were 96.77%(30/31), 3.33%(1/31). The RR of the two group were both 100%, no stable disease(SD) and progressive disease(PD). The complete remission rate, partial remission rate and overall efficiency had no significant difference. 1-year and 2-year overall survival rate had no significant difference, 1-year tumor free survival rate was statistically significant different(χ2=4.969, P = 0.026), but 2-year free survival rate not(χ2=2.597, p=0.107); 2-year local progression rate had statistical significance difference(χ2=5.130, P = 0.024), but 1-year local progression rate not(χ2=1.870, P = 0.171); 1-year and 2-year distant recurrence intrahepatic rate had significant difference.Conclusion It is essential to combine MWA with TACE for therapy of small and moderate primary hepatic carcinoma. Combined therapy do not increase complications, but can reduce short-term recurrence and improve tumor-free survival. However the liver damage heavier, average stay longer than that of MWA alone. Combined therapy don’t add the recent survival rate.