Clinical Analysis Of Hepatic Artery Chemoembolization Combined With Radiofrequency Ablation Versus Radiofrequency Ablation Alone In The Treatment Of CNLC Stage Ⅰ Hepatocellular Carcinoma

Objective To investigate the need for combined therapy by retrospectively analyzing the clinical analysis of transhepatic artery chemoembolization combined with radiofrequency ablation versus radiofrequency ablation alone for the treatment of CNLC stage I hepatocellular carcinoma.Methods The study included 54 patients who received TACE-RFA and 48 patients who were treated with RFA alone as the only first-line treatment in 102 cases between January2018 and December 2021.The near-term efficacy,methemoglobin regression,long-term survival,complications and adverse effects,and factors influencing the prognosis of hepatocellular carcinoma were compared between the two treatments.Results There were no statistically significant differences in ORR and DCR at 1month,3 months and 6 months after surgery between the two groups(P > 0.05).Hepatic artery chemoembolization combined with radiofrequency ablation appeared to result in more frequent need for medication and more adverse effects and morbidities in patients compared with radiofrequency treatment alone(P < 0.05).After 1 month postoperatively,the conversion rate was significantly better in the combined group than in the simple group(P<0.05);while the change in methemoglobin between the two groups at 3 months postoperatively was not significant(P>0.05).The overall survival rates at 12,24 and 36 months were 88.2%,84.3%and 76.5% in the two groups,respectively;the survival rates at 12,24 and 36 months were87.5%,83.3% and 70.8% in the control group,and the survival rates at 12,24 and 36 months were 88.9%,85.2% and 81.5% in the observation group,respectively.81.5%,with no statistically significant difference(P > 0.05).The overall progression-free survival mean survival time was 27.8±1.4(95% CL: 25.0-30.6 months);the progression-free survival time in the control group was 25.9±2.2 months(95% CL: 21.5-30.2 months)The progression-free survival time in the observation group was 29.4±1.8 months(95% CL: 25.7-33.0 months)The difference was not statistically significant(P=0.221).The efficacy of treatment in both groups was similar for tumor diameters less than 3 cm and >3 cm(P > 0.05).Statistically significant variables from the univariate analysis were included in the Cox proportional risk model for multifactorial analysis,yielding GGT as an independent risk factor for overall survival.Conclusion1.for patients eligible for Chinese hepatocellular carcinoma staging cnlc stage I,TACE+RFA was not significantly different from RFA alone in terms of near-term efficacy progression-free survival and overall survival and appeared to result in more adverse effects and complications.2.The combination was more advantageous compared to RFA alone in terms of short intra-return period of methemoglobin3.GGT was an independent risk prognostic factor for overall survival.4.Combination therapy has the same efficacy as RFA alone for tumors <3 cm in diameter and ≥3 cm in diameter,but the data in this subgroup are small and need to be clinically validated in a large sample.