Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2783-2791
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2783
Percutaneous microwave ablation and transcatheter arterial chemoembolization for serum tumor markers and prognostics of middle-late primary hepatic carcinoma
Zhi-Peng Lin, Da-Bei Huang, Xu-Gong Zou, Yuan Chen, Xiao-Qun Li, Jian Zhang
Zhi-Peng Lin, Da-Bei Huang, Xu-Gong Zou, Yuan Chen, Xiao-Qun Li, Jian Zhang, Department of Interventional Medicine, Zhongshan People’s Hospital, Zhongshan 528400, Guangdong Province, China
Author contributions: Lin ZP performed the research and wrote the paper; Huang DB designed the research; Zou XG contributed to the analysis; Chen Y and Li XQ organized the materials; Zhang Jie guided and supervised the research.
Institutional review board statement: The study was reviewed and approved by the Zhongshan People’s Hospital Institutional Review Board (Approval No. 2023-038).
Informed consent statement: This is a retrospective study article, which selected anonymous patients from the hospital system. The patient's identity information was not disclosed and will not cause any harm to the patient. An application for exemption from informed consent has been made to the ethics committee.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Clinical data used in this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Zhang, MD, Professor, Department of Interventional Medicine, Zhongshan People’s Hospital, No. 2 Sun Wen East Road, Zhongshan 528400, Guangdong Province, China. wy18988583838@163.com
Received: October 26, 2023
Peer-review started: October 26, 2023
First decision: November 8, 2023
Revised: November 17, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: December 27, 2023
Processing time: 62 Days and 9.6 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with middle-late primary hepatic carcinoma (PHC) exhibit distinct characteristics, such as large tumors, multiple tumor lesions, and satellite lesions. Achieving a good embolization effect after multiple transcatheter arterial chemoembolization (TACE) treatments can often be challenging. percutaneous microwave coagulation therapy (PMCT) can accurately reach the tumor site, heat the tumor locally, and cause coagulation necrosis. Currently, TACE plus PMCT is more effective than interventional therapy alone and can improve survival time. However, there are few reports on the effects of TACE and PMCT on serum markers and the prognosis of patients with advanced PHC.

Research motivation

Compared to single TACE therapy, TACE + PMCT has a better effect in clinical applications. However, most studies have focused on efficacy and safety, and there are few reports on the factors affecting the prognosis of patients with middle-late PHC and the improvement of tumor markers in patients treated with TACE + PMCT.

Research objectives

To explore the effect of TACE + PMCT on tumor markers and prognosis in patients with mid-late PHC.

Research methods

Patients were divided into a single group (TACE treatment) and a combination group (TACE + PMCT treatment), according to the treatment methods. Serum tumor markers [alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9)] and the clinical efficacy of the single and combined groups were observed before treatment and 4 wk after treatment. The 1-year survival rates and prognostic factors of the two groups were analyzed.

Research results

The objective response rate in the combined group was 74.67%, higher than that in the single group (50.67%) (P < 0.05). After 4 wk of treatment, the serum AFP, CEA, and CA19-9 Levels in the single and combined groups decreased, with the decrease in the combined group being more significant (P < 0.05). The 1-year survival rate at the end of the follow-up period was 80.00% in the combined group and 60.00% in the single group (P < 0.05). The average survival time in the combined group was 299.38 ± 61.13 days, longer than that in the single group (214.41 ± 72.97 d, P < 0.05). COX analysis revealed the effect of tumor diameter, the number of tumors, and the treatment method on the prognosis of patients with middle-to-the newest PHC (P < 0.05).

Research conclusions

TACE + PMCT has good clinical efficacy in the treatment of mid-late PHC and can effectively improve the survival rate of patients. Tumor diameter, number, and treatment method were related to the prognosis of patients with mid-late PHC.

Research perspectives

This study provides a reference for the clinical management of patients with mid-late PHC.