Prognostic Risk Factors And Therapeutic Effect Of Radiofrequency Ablation Combine With TACE Or PEI For Small Liver Cancer Located In The First And Second Hepatic Portal

Objective: To investigate the effect and the prognostic risk factors of percutaneous radiofrequency ablation(PRFA)combine with transcatheter arterial chemoembolization(TACE)or percutaneous ethanol injection(PEI)for primary hepatic carcinoma(PHC)located in the first and second hepatic portal.Methods : A total number of 60 patients with small primary liver cancer(?5cm)confirmed clinically or pathologically located in the first or second hepatic portal under ultrasound-guided PRFA combine with TACE or PEI from Jan.2008 to Jun.2012 were retrospectively analyzed.The efficiency was evaluated with univariate analysis and the prognostic risk factors were analyzed with Cox`s regression analysis model.Results : 76.7% patients postoperative AST and ALT increased significantly,All patients showed no significant change in postoperative bilirubin,no bile duct stricture?bile leak?liver abscesses?bleeding and other serious complications occurred.The rate of AFP positive down to negative was 72.1%,The complete necrosis rate of 61 lesions close to the hepatic portal was 91.8% in one month after RFA.The 1,3,5-year disease-free survival rate was 81.7%,46.7% and 33.3%,The 1,2,3,5-year overall survival rate was 91.7%,80.0%,61.7%,34.9%.The Cox regression models showed that the independent factors affecting the prognosis of patients were preoperative liver function of Child-Pugh stage,whether or not combined with TACE,the number of tumors,tumor size.Conclusion: PRFA under ultrasound-guided combine with TACE or PEI is a feasible and effective treatment for small liver cancer located in the first or second hepatic portal.Child-Pugh stage of liver function,whether or not combined with TACE,the number of tumors and tumor size are the independent prognostic factors.