Clinical efficacy analysis of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in primary liver cancer and recurrent liver cancer

Purpose: To compare the efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in primary hepatocellular carcinoma and recurrence of hepatocellular carcinoma after hepatectomy, and analysis the prognostic factors affecting therapeutic outcomes. Methods: A total of 132 hepatocellular carcinoma patients treated with TACE combined with RFA were divided into primary group (n=89) and recurrent group (n=43). Their clinical date were reviewed. The overall survival (OS), tumor-free survival (TFS) and safety between 2 groups were compared. Prognostic factors were analyzed with univariate and multivariate analyses. Results: OS rates at 1 and 3 years were 94.4% (84/89) and 70.8% (63/89) in the primary group, and TFS were 76.4% (68/89) and 37.1% (33/89), respectively. The OS rates in the recurrent group were 93.0% (40/43) and 65.1% (28/43), and TFS rates were 41.9% (18/43) and 13.9% (6/43), respectively. The OS rates had no significant difference between 2 groups (chi(2)=0.0068, 0.4353, p=0.9342, 0.5094), but the TFS rates in primary group were significantly higher than in the recurrent group (chi(2)=15.2378, 7.4483, p=0.0001, 0.0063). Multivariate analysis identified presence of portosystemic collaterals, AFP level, total bilirubin and Child-Pugh grading as factors affecting OS, and the presence of portosystemic collaterals and AFP level were two unfavorable prognostic factors influencing TFS. Conclusions: TACE combined with RFA is helpful in improving the survival rate of patients with primary and recurrent hepatocellular carcinoma. Presence of portosystemic collaterals, AFP level, ptotal bilirubin and Child-Pugh grading were the factors affecting OS.