Abstract

The aim of this study was to evaluate the outcome of transhepatic arterial chemoembolization in combination with local thermal ablation on large hepatocellular carcinoma, and to analyse risk factors. Ninety patients with large hepatocellular carcinoma admitted to the Second Affiliated Hospital of Soochow University from January 2017 to December 2019 were enrolled to receive transhepatic arterial chemoembolization combined with local thermal ablation. The short-term efficacy was then evaluated and the objective response rate was analysed. According to the short-term efficacy, the patients were assigned into objective response group and control group (no objective response was achieved) and their clinical data were compared. Related risk factors were subjected to univariate analysis and multivariate logistic regression analysis. After transhepatic arterial chemoembolization combined with local thermal ablation, 47 out of 90 patients with large hepatocellular carcinoma achieved an objective response, whereas the remaining 43 patients failed to do so, with an objective response rate of 52.22 %. According to univariate analysis, there were significant differences in the diameter, number and clinical stage of tumours, preoperative α-fetoprotein level and portal vein tumour thrombus between the two groups, but no significant differences in the age, sex and body mass index. Based on multivariate logistic regression analysis, the tumour diameter of ≥7 cm, tumour number of ≥2, clinical stage III-IV, preoperative α-fetoprotein level of ≥200 μg/l and presence of portal vein tumour thrombus were risk factors affecting the treatment outcomes. Transhepatic arterial chemoembolization in combination with local thermal ablation exerted obvious therapeutic effects on large hepatocellular carcinoma. However, the treatment outcomes are affected by the diameter, number and clinical stage of tumours, preoperative α-fetoprotein level and portal vein tumour thrombus. Therefore, corresponding interventional measures should be taken based on the above risk factors.