Retrospective Study
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World J Gastroenterol. Dec 14, 2014; 20(46): 17483-17490
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17483
Prognostic factors for survival after transarterial chemoembolization combined with microwave ablation for hepatocellular carcinoma
Jia-Yan Ni, Hong-Liang Sun, Yao-Ting Chen, Jiang-Hong Luo, Dong Chen, Xiong-Ying Jiang, Lin-Feng Xu
Jia-Yan Ni, Hong-Liang Sun, Yao-Ting Chen, Jiang-Hong Luo, Dong Chen, Xiong-Ying Jiang, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
Author contributions: Ni JY designed the research; Ni JY and Sun HL performed the research; Chen YT and Luo JH contributed analytic tools; Ni JY, Chen D and Jiang XY analyzed the data; Ni JY wrote the paper; Xu LF designed the study and provided financial support for this work.
Correspondence to: Lin-Feng Xu, MD, PhD, Chief, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang Road West, Guangzhou 510120, Guangdong Province, China. xu_lin_feng@163.com
Telephone: +86-20-81332269 Fax: +86-20-81332269
Received: April 30, 2014
Revised: July 5, 2014
Accepted: September 12, 2014
Published online: December 14, 2014
Abstract

AIM: To analyze prognostic factors for survival after transarterial chemoembolization (TACE) combined with microwave ablation (MWA) for hepatocellular carcinoma (HCC).

METHODS: Clinical data of 86 patients who underwent TACE combined with MWA between January 2006 and December 2013 were retrospectively analyzed in this study. Survival curves were detected using log-rank test. Univariate analysis was performed using log-rank test with respect to 13 prognostic factors affecting survival. All statistically significant prognostic factors identified by univariate analysis were entered into a Cox proportion hazards regression model to identify independent predictors of survival. P values were two-sided and P < 0.05 was considered statistically significant.

RESULTS: Median follow-up time was 47.6 mo, and median survival time of enrolled patients was 21.5 mo. The 1-, 2-, 3- and 5-year overall survival rates were 72.1%, 44.1%, 31.4% and 13.9%, respectively. Tumor size(χ2 = 14.999, P = 0.000), Barcelona Clinic Liver Cancer (BCLC) stage (χ2 = 29.765, P = 0.000), Child-Pugh class (χ2 = 51.820, P = 0.000), portal vein tumor thrombus (PVTT) (χ2 = 43.086, P = 0.000), arterio-venous fistula (χ2 = 29.791, P = 0.000), MWA therapy times (χ2 = 12.920, P = 0.002), Eastern Cooperative Oncology Group (ECOG) score (χ2 = 28.660, P = 0.000) and targeted drug usage (χ2 = 10.901, P = 0.001) were found to be significantly associated with overall survival by univariate analysis. Multivariate analysis identified that tumor size (95%CI: 1.608-4.962, P = 0.000), BCLC stage (95%CI: 1.016-2.208, P = 0.020), PVTT (95%CI: 2.062-9.068, P = 0.000), MWA therapy times (95%CI: 0.402-0.745, P = 0.000), ECOG score (95%CI: 1.012-3.053, P = 0.045) and targeted drug usage (95%CI: 1.335-3.143, P = 0.001) were independent prognostic factors associated with overall survival.

CONCLUSION: Superior performance status, MWA treatment and targeted drug were favorable factors, and large HCC, PVTT and advanced BCLC stage were risk factors for survival after TACE-MWA for HCC.

Keywords: Hepatocellular carcinoma, Transarterial chemoembolization, Microwave ablation, Survival, Prognosis

Core tip: Transarterial chemoembolization (TACE) combined with microwave ablation (MWA) has been used more and more widely for treatment of patients with hepatocellular carcinoma (HCC). However, there has been no study designed to analyze prognostic factors for survival after TACE combined with MWA for HCC. In this study, we retrospectively collected clinicopathologic data of 86 patients who were treated by TACE sequentially combined with MWA, and to analyze prognostic factors for survival after the combinational therapy. We hope that our finding could serve as significant information for clinicians and patients in the decision for selecting treatment strategies.