Abstract:

Background and purpose: There is still no definite conclusion whether transcatheter arterial chemoembolization (TACE) is an absolute contraindication to the treatment for primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Aim of the current study was to investigate the prognostic factors of HCC with PVTT treated by TACE combined with radiofrequency ablation (RFA). Methods: We retrospectively analyzed the medical records and follow-up data of 157 patients who underwent TACE combined with RFA in the Affiliated Tumor Hospital of Zhengzhou University from January 1, 2011 to December 31, 2013. The relationships between demographic data, serological markers, clinical data and 3-year survival rate, tumor metastasis and recurrence were analyzed by univariate and multivariate Cox regression analysis. Results: Multivariate Cox regression analysis showed that higher serum albumin (ALB) level was the protective factor for the survival of patients with HCC and PTVV after TACE combined with RFA treatment and reduced the risk of tumor recurrence and metastasis after adjustment and control of other factors. High levels of alpha-fetoprotein (AFP), alanine aminotransferase (ALT) and aspartate transaminase (AST), portal vein trunk suppositories and mixed tumor thrombus, and higher stage of the Child Pugh classification were independent risk factors of 3-year survival. High levels of AFP and AST, portal vein trunk suppositories and mixed tumor thrombus were independent risk factors of tumor recurrence and metastasis. Conclusion: TACE combined with RFA is not an absolute contraindication for the treatment of HCC with PVTT, the prognosis affected by a variety of factors. Evaluating the relevant factors of each patient before treatment may be helpful in choosing the better indications and assessing the possible prognosis to improve HCC treatment.

Key words: Transcatheter arterial chemoembolization, Radiofrequency ablation, Primary hepatocellular carcinoma, Portal vein tumor thrombus, Prognosis