Risk factors of prognosis of intermediate and advanced hepatocellular carcinoma after TACE
10.13929/j.issn.1672-8475.2024.11.003
- VernacularTitle:中晚期肝细胞癌经TACE后预后危险因素
- Author:
Shuaibing LIANG
1
;
Jie TAN
;
Bin XIANG
Author Information
1. 湖南省人民医院 湖南师范大学第一附属医院介入血管外科,湖南 长沙 410002
- Keywords:
carcinoma,hepatocellular;
chemoembolization,therapeutic;
neoplasm metastasis
- From:
Chinese Journal of Interventional Imaging and Therapy
2024;21(11):659-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of prognosis of intermediate and advanced hepatocellular carcinoma(HCC)after TACE.Methods Totally 103 patients with intermediate and advanced HCC who underwent TACE as initial treatment were retrospectively enrolled,and extrahepatic metastasis(EHM)and overall survival(OS)after TACE during follow-up were recorded.Basic clinical information,laboratory and imaging examinations as well as TACE related data were analyzed with univariate and multivariate Cox regression analysis to screen the risk factors of EHM and OS after TACE in patients with intermediate and advanced HCC.Results One month after the first TACE,among 103 cases,objective remission was observed in 84 cases,while no response was noticed in 19 cases.During follow-up of 3-50 months(median of 16.9 months),EHM occurred in 34 cases,and 70 cases died.Before TACE α-fetoprotein(AFP)≥400 ng/ml(HR=3.451)and ineffective initial TACE(HR=3.049)were both independent risk factors for EHM in intermediate and advanced HCC after TACE(both P＜0.05).Before treatment alkaline phosphatase(ALP)≥100 U/L(HR=2.193),platelet to lymphocyte ratio(PLR)≥125(HR=1.737),liver function Child-Pugh stage B(HR=2.417)and EHM within 1 year after the initial TACE(HR=4.488)were all independent risk factors for OS(all P＜0.05).Conclusion Before treatment AFP≥400 ng/ml and ineffective initial TACE were both independent risk factors for EHM in intermediate and advanced HCC.Increased ALP and PLR,decreased liver function before TACE and early EHM after the initial TACE might shorten OS of patients with intermediate and advanced HCC.
