Clinical Significance Of Adjuvant TACE Therapy In Patients With Hepatocellular Carcinoma After Palliative Resection And Analysis Of Risk Factors For Long-term Survival

Objectives: To compare the therapeutic effects between palliative resection of hepatocellular carcinoma(HCC) combined with postoperative adjuvant TACE therapy and palliative resection of HCC, investigate the clinical significance of adjuvant TACE therapy in the treatment of HCC after palliative resection and analyse the risk factors of carcinoma recurrence.Methods: Retrospective analysis of the clinical data of 114 cases of palliative hepatectomy in the hepatic surgery centre of our hospital from January 1, 2012 to June 31, 2015, all cases were confirmed as HCC by postoperative pathology. The 114 cases were divided into two groups. The experimental group(n=51) received adjuvant TACE therapy within two months after palliative hepatectomy, and the control group(n=63) only received palliative hepatectomy. The postoperative cumulative survival rate of 0.5,1,2 years and the clinical data of two groups were analyzed retrospectively.Results: By the end of December 31, 2015, the 0.5,1,2-year of cumulative survival rates in all cases after palliative hepatectomy were 63.2%, 37.7% and 1.8% retrospectively, and the median survival time was 10.4 months, the 0.5,1,2-year of cumulative survival rates in the experimental group and the control group are 68.6%, 47.1%, 2.0% and 58.7%, 30.2%,1.6% retrospectively, and the median survival time was 11.7 months and 9.3 months retrospectively. The overall survival rates and median survival time of experimental group are better than the control group, there is statistical significance(P=0.03). COX regression analysis shows that preoperative tumor rupture, tumor diameter larger than 5cm, multiple tumors, microvascular invasion are independent risk factors for poor prognosis(P < 0.05). Receiving postoperative adjuvant TACE therapy is a protective factor for the survival of the patients after operation.Conclusion: 1. Adjuvant TACE therapy after palliative resection of HCC can help to improve the overall survival of patients, but the effect of long-term survival is poor. 2.Adjuvant TACE therapy after palliative resection is the protective factors of postoperative survival, and repeated TACE therapy is better than single.3. Preoperative tumor rupture, tumor diameter larger than 5cm, multiple tumors, microvascular invasion are independent risk factors for poor prognosis.