Prognostic Factors Of Transcatheter Arterial Chemoembolization For BCLC Stage B Hepatocellular Carcinoma

Objective:Hepatocellular carcinoma(HCC)is one of the common malignant tumors in the world,but only 20% of patients can undergo surgical resection.In recent years,with the rapid development of interventional therapy,it has become the most important treatment for patients with liver cancer in China.At present,the Barcelona liver cancer staging system(BCLC)is the basis of HCC diagnosis and treatment.According to BCLC guideline,the first choice for BCLC B stage HCC is hepatic artery chemoembolization(TACE).The purpose of this study is to explore the prognostic factors of BCLC B stage HCC treated with TACE,and to evaluate the efficacy after treatment,improve the effect of interventional therapy for hepatocellular carcinoma.Material and Methods:A retrospective analysis was performed on 314 HCC patients treated with TACE in Affiliated Cancer Hospital of Zhengzhou University from November 2012 to February 2016 were included in this study.Kaplan-Meier method was used to calculate the 1-year,2-year and 3-year cumulative survival rates.Log-rank test and Cox proportional hazards model was used to analyze univariate and multivariate prognostic factors,respectively.Further analysis was specifically obtained for the BCLC B stage HCC subclassifications.The curative effect evaluation criteria(m RECIST standard)of solid tumor treatment was used to determine the short-term effect after treatment.Result:The 1-year,2-year and 3-year cumulative survival rate of HCC patient was 74.50%,40.20% and 16.10%,respectively.The median survival time was 21 months.Univariate analysis showed that the alpha-fetoprotein(AFP),gamma-glutamyl transpeptidase(GGT),tumor size,tumor number,Child-Pugh grade,Barcelona clinic liver cancer(BCLC)stage,treatment times and treatment method were factors affecting the prognosis of HCC patient(all P<0.05).Multivariate COX regression analysis showed that AFP,GGT,treatment times,and Child-Pugh classification were the independent prognostic factors of HCC patient(all P<0.05).The patients were grouped by BCLC substage method(B1 n = 99,B2 stage n = 175,B3 stage n = 26,B4 stage =14),median survival time was 26,19,15,9(months).Conclusion:AFP,GGT,treatment times and Child Pugh classification are independent risk factors that of TACE for treating BCLC B stage HCC patients.The BCLC B subgroup has a certain clinical significance for the patients with hepatocellular Carcinoma(BCLC B stage).