Different Treatment For Hepatocellular Carcinoma Patients With Cirrhosis Of Esophageal And Gastric Varices

Objective:To investigate the efficacy of combination of some interventional treatments(transarterial chemoembolization(TACE),radiofrequency ablation(RFA))and endoscopic treatment compare with some interventional treatments(transarterial chemoembolization(TACE),radiofrequency ablation(RFA))alone in hepatocellular carcinoma patients with cirrhosis of esophageal and gastric varices.Methods:A total of 35 patients with hepatocellular carcinoma patients with cirrhosis of esophageal and gastric varices were involved in this study.16 patients,13 males and 3 females,underwent some interventional treatments plus endoscopic treatment(mean age 57.13±7.51 years,the combined treatment group).19 patients,15 males and 4 females,underwent some interventional treatments(mean age 60.31±9.38 years,the alone treatment group).Then those tests,including liver function,blood routine tests,renal function,blood coagulation parameters,alpha fetoprotein,abdominal ultrasonography or CT,Child-Pugh class,hepatocellular carcinoma stage and ECOG score were performed and evaluated at preoperative.Follow-up patients' survival time and occurrence of rebleeding,analysis of survival rate,incidence of rebleeding and possible risk factors.Results:Follow-up until March 1,2018,During the following period,three patients lost to follow-up(8.57%),The median survival(mouth)of the combined treatment group was 34 months while 16 mouths of the alone treatment group.Comparison of the 1-yr,2-yr,3-yr survival rates between the two groups(87.5%,37%,16%VS 35.7%,22.2%,0%,P=0.0244),the survival rates of the combined treatment group was significantly higher than that of the alone treatment group.The incidence of the combined treatment group and the alone treatment group rebleeding was 12.5%vs.52.6%,and the difference between the two groups was statistically significant(P=0.013).Correlation analysis revealed that the occurrence of rebleeding,platelet,alpha fetoprotein,Child-Pugh score,and portal vein tumor embolus were related factors affecting the survival rate of hepatocellular carcinoma patients with cirrhosis of esophageal and gastric varices(P<0.05),Age,treatment,and albumin are related factors affecting rebleeding in hepatocellular carcinoma patients with cirrhosis of esophageal and gastric varices(P<0.05).Conclusion:some interventional treatments(transarterial chemoembolization(TACE),radiofrequency ablation(RFA))plus endoscopic treatment is safe,effective and feasible for the hepatocellular carcinoma patients with cirrhosis of esophageal and gastric varices,It can prolong the survival time and prevent the rebleeding of esophageal and gastric varices.