The Curative Effect of Auxiliary Hepatic Arterial Chemoembolization in the Treatment of Microvascular Invasion of Hepatocellular Carcinoma
10.3969/j.issn.1003-4706.2018.08.019
- VernacularTitle:辅助性肝动脉化疗栓塞治疗肝细胞癌微血管浸润的疗效
- Author:
Bo-Yan TIAN
1
;
Qin-Ling YANG
;
Jiao-Qiong ZHANG
;
Na HAN
;
Shao-Hua LIU
Author Information
1. 西安交通大学第一附属医院肝胆外科
- Keywords:
Hepatocellular carcinoma;
Transcatheter arterial chemoembolization;
Microvascular invasion;
Efficacy
- From:
Journal of Kunming Medical University
2018;39(8):86-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the recurrence rate, the efficacy and safety of auxiliary hepatic arterial chemoembolization after the treatment of microvascular invasion (MIV) of hepatocellular carcinoma. Methods A total of 104 patients with hepatocellular carcinoma clinical staging of early metaphase were collected from the First Affiliated Hospital of Xi'an Jiaotong University in Jan.2010 to Dec.2016, all treated with liver resection and follow-ups. Adopting the method of retrospective analysis, univariate and multivariate analyses were performed to investigate the risk factors for recurrence-free survival (RFS) and overall survival (OS). Multiple logistic regression was used to identify the clinicopathological characteristics associated with MVI. The rates of RFS and OS were compared among patients with or without MVI treated with liver resection alone or followed by PA-TACE. Results In HCC patients, the gender HBs Ag, total bilirubin, and prothrombin time, AFP, HBV-DNA, the size of largest tumor, capsule, operation type, hepatic door block, Child-Pugh grade, classification comparison differences had no statistical significance between the two groups of with or without TACE (P＞0.05); Age, nodules, tumor cell resection, and BCLC were statistically significant in the non-MIV infiltration group (P＜0.05).Hypersplenism and recurrence rate were statistically significant in MIV group (P＜0.05).Univariate and multivariate analyses demonstrated that AFP (＞ 400 ng/m L), tumor diameter, membrane integrity, MVI, and most liver resection were significantly associated with overall survival rates (P＜0.05), the AFP (＞400 ng/m L), Child-Pugh, grade B, tumor diameter, hepatocellular carcinoma (HCC) and other abnormal degree, membrane integrity, MVI have significant correlation with disease-free survival rate (P＜0.05). Multiple logistic regression identified serum AFP level＞ 400 ng/L, tumor size＞ 5 cm, and incomplete tumor envelope was independent correlation factor (P＞0.05). In the HCC patients with MIV, both OS and DFS were significantly improved in patients who received PA-TACE as compared to those who underwent liver resection alone (P＞ 0.05), but no significant effect in HCC patients wieh no MIV invasion (P＞ 0.05).Conclusions There is a certain correlation between microvascular infiltration and the recurrence rate and survival rate of hepatocellular carcinoma, and the method of using adjuvant hepatic arterial chemoembolization is helpful to reduce the recurrence rate and prolong the survival period.
