The Clinical Study Of Efficiency Of Combined Anatomical Liver Resection With Radiofrequency Ablation For Hepatocellular Carcinoma In The Barcelona Clinic Liver Cancer Stage B Classification

Objective:This study is to investigate the efficiency and clinical value of radiofrequency ablation combined with anatomical liver resection in the treatment of stage B patients in Barcelona Clinic Liver Cancer,Methods: A retrospective analysis have been executed from January 2013 to January 2016 in the first hepatobiliary pancreatic ward of the Second Affiliated Hospital of Kunming Medical University.A total of 70 consecutive patients with multifocal tumors meeting the Barcelona Clinic Liver Cancer stage B and Child-Pugh A. All the patients included in the study have never received the treatment of anti-tumor drugs and related surgery before being separated two groups.Among them,no symptoms such as ascites, hepatic encephalopathy, and portal hypertension were found in the preoperative examinations.By preoperative imaging(ultrasound, enhanced CT and MRI) examinations, the Barcelona Clinic Liver Cancer stage system, the Child-Pugh score system, performance state and the evaluations of vital organs, they have undergone comprehensive and systematic assessment.The result shows that all the patients could tolerate the risk of receiving operation.29 patients receive radiofrequency ablation combined with anatomical liver resection,meanwhile 41 patients undergo transarterial chemoembolization.Perioperative complications are evaluated by observing the 3rd day and 7th day of outcomes after operation. AFP, enhanced CT,ultrasound should be reviewed in a month later and follow up regularly.Different statistical methods are used to compare the survival rates of two groups.Overall survival rates and recurrence-free survival rates are analyzed by using Kaplan-Meier curves,whereas risk factors are analyzed by using the Cox regression model.Results:1.Radiofrequency ablation combined with anatomical liver resection group of 29 cases,20 cases of the patients’reviews could acquire complete remission at the rate of 69% in a month later.1,2,3 year overall survival rate were 72.4%,65.5%, 44.8%,respectively.1,2,3 year recurrence-free survival rates were 62.1%,20.7%, 17.2%,respectively. the median survival times were 27 months.2.In TACE group of 41 cases, of 17 patients achieved complete remission at rate was 41.5%. The 1,2,3 year overall survival rate of patients in group TACE were 48.8%,26.8%,17.1%,1 years recurrence-free survival rate was 4.9%, the median survival times were 11 months (p<0.05)3.Cox regression model suggested that the number of tumor and treatment groups were identified as significant prognostic factors for overall survival(p< 0.001), RR=26.72,95%CI:4.38-163.11;RR=7.77,95%CI:3.58-16.87,respectively.Conclusions:1.RFA combined with anatomical liver resection, a aggressive treatment,has been considered as a safe and effective one for the HCC patients with multifocal tumors meeting BCLC stage B and Child-Pugh A.2.Compared with the TACE group, the patients’survival could be prlonged in combined treatment group and this group yielded better long-term outcomes.3. Tumor numbers and treatment groups are identified as significant prognostic factors for overall suvival in patients.