Feasibility And Clinical Efficacy Analysis Of Transarterial Chemoembolization Combined With Radiofrequency Ablation For The Treatment Of Hepatocellular Carcinoma Involved The Second Hepatic Hilar Region

Objective:To explore the feasibility and clinical efficacy of transarterial chemoembolization(TACE)combined with radiofrequency ablation(RFA)for the treatment of hepatocellular carcinoma involved the second hepatic hilar region.Material and Methods:A total of fifty-one patients with hepatocellular carcinoma(HCC)involved the second hepatic hilar region underwent TACE combined with RFA at the minimally invasive interventional department of our Hospital from March 2014 to October 2018.There were fifty-four tumors involved the second hepatic hilar region in the fifty-one patients.The clinical data of all patients were collected,meanwhile the overall survival(OS)time and complications were counted.All patients routinely received liver protection and reducing bilirubin therapy after TACE.RFA was performed on all lesions after liver function was restored to Child-Pugh A or B one week after TACE.The Kaplan-meier method was used to draw survival curve,and calculated the cumulative survival rate of 1,2 and 3 years,the median OS and the median progression-free survival(PFS).The log-rank test was used for univariate analysis.The cox proportional hazards model was used for multivariate analysis.The paired sample t-test was used for the laboratory examination indexes before and after treatment.Result:The complete ablation rate of tumors involved second hepatic hilar region was 81.48%(44/54),and the partial ablation rate was 18.52%(10/54).The 1,2,3-year cumulative overall survival rates were 90.20%,57.50%,31.00%,respectively.The median OS was 28 months;the median PFS was 9 months;univariate and multivariate analysis showed preoperative AFP(?400 or>400 ng/ml)and the number of intrahepatic tumors(including tumors involved the second hepatic hilar region,?2 or>2)were independent risk factors(P<0.05).The incidence of severe complications(pneumothorax in 3cases,pleural effusion in lcase,and bleeding in 1 case)in all patients was 9.80%(5/51).There are no treatment related death.Conclusion:TACE combined with RFA can effectively treat HCC involved second hepatic hilar region with fewer complications and better prognosis.Preoperative AFP(?400 or>400 ng/ml)and the number of intrahepatic tumors(including tumors involved the second hepatic hilar region,?2 or>2)were independent risk factors affecting the prognosis of patients.