Efficacy Evaluation Of FOLFOX4 Chemotherapy With Portal Vein Infusion In Patients With Hepatocellular Carcinoma Complicated With Portal Vein Thrombus After Tumor Resection

Objective:to investigate the efficacy and safety of FOLFOX4 chemotherapy with portal vein infusion in patients with primary liver cancer complicated with portal vein thrombus after tumor resection.Methods:A retrospective analysis was performed on the complete clinical data of 52patients with primary liver cancer with portal vein thrombus admitted to our hospital from March 2017 to October 2019.Group A,FOLFOX4 chemotherapy with portal vein infusion after tumor resection and portal vein thrombus resection;Group B,simple surgery group,simple tumor resection and portal vein thrombus resection;Group C and TACE group,simple transarterial artery chemoemboization.Group D,TACE+¹²⁵I seed implantation group,transarterial artery chemoemboization and¹²⁵I seed implantation.Postoperative survival,postoperative tumor progression time,hospitalization time,hospitalization cost and postoperative complications were observed.Results:1.The average survival time of group A?n=9?undergoing portal vein perfusion chemotherapy after surgery was 18 months,and the survival rates of 0.5 year,1year and 1.5 year were 90.0%,73.2%and 53.0%,respectively.The average survival time in group B?n=12?was 13 months,and the survival rates of 0.5 year,1 year and 1.5 year were 90.0%,37.2%and 27.3%,respectively.The average survival time of the TACE group in group C?n=13?was 7 months,and the survival rates of 0.5 year,1 year and 1.5 year were 33.8,11.3%,0%and 0,respectively.The average survival time of the TACE+125I seed implantation group in group D?n=18?was 11 months,and the survival rates of 0.5year,1 year and 1.5 year were 76.4%,22.4%and 0%,respectively.Compared with other treatment groups,the survival rate of group A was better than that of other treatment groups,and the difference was significant?P<0.05?.The average time of tumor progression in group A,group B,group C and group D was 13 months,6 months,2 months and 4months,respectively.Compared with other treatment groups,the time of tumor progression of group A was better than that of other treatment groups,and the difference was significant?P<0.05?.2.Univariate analysis showed that treatment pattern?P=0.001?and tumor size?P=0.040?were important factors affecting patient prognosis.3.COX multivariate analysis was used to analyze the treatment pattern and tumor size among each group,which were important independent factors affecting the prognosis of patients.4.There was no significant difference in length of stay between group A and group B?P value>0.05?,and the length of stay between group A and group B was significantly longer than that between group C and group D?P<0.001?,which was statistically significant.There was no significant difference in length of stay between group C and group D?P value>0.05,which was not statistically significant?.There was no significant difference in hospitalization expenses between group A and group B?P value>0.05?,and the hospitalization expenses of group A and group B were significantly higher than those of group C and group D?P<0.001?,which was statistically significant.There was no significant difference in hospitalization expenses between group C and group D?P value>0.05,which was not statistically significant?.5.Comparison of complications:gastrointestinal bleeding,infection,pleural effusion,peritoneal effusion,bile leakage and other complications occurred in group A and group B after surgery,which were all improved after symptomatic treatment,and no serious complications of liver failure occurred.There was no significant difference in postoperative complications between the two groups,with A P value of>0.05.Between group A and group C and group D via the portal vein and hepatic artery perfusion chemotherapy drugs,chemotherapy after abdominal pain,abdominal distention,nausea,vomiting,fever,subcapsular effusion,decreased white blood cells,blood oxygen saturation decreased complications,such as after symptomatic treatment were improved,after chemotherapy complication was no significant difference between groups,P values>0.05.Conclusion:1.The survival prognosis of the treatment group with portal vein chemotherapy for hepatocellular carcinoma with portal vein thrombus was significantly improved compared with other groups.2.Postoperative treatment and tumor volume were independent factors affecting the prognosis.3.The length and cost of hospitalization in the portal vein chemotherapy group and the surgery group after liver cancer surgery were more than that in the TACE group and the TACE+¹²⁵I seed implantation group.4.Postoperative portal vein chemotherapy for hepatocellular carcinoma was of high safety,and there was no significant difference in postoperative complications compared with other groups.