title: Prognostic factors for survival after transarterial chemoembolization combined with microwave ablation for hepatocellular carcinoma.
abstract: OBJECTIVE
  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(χ(2) = 14.999, P = 0.000), Barcelona Clinic Liver Cancer (BCLC) stage (χ(2) = 29.765, P = 0.000), Child-Pugh class (χ(2) = 51.820, P = 0.000), portal vein tumor thrombus (PVTT) (χ(2) = 43.086, P = 0.000), arterio-venous fistula (χ(2) = 29.791, P = 0.000), MWA therapy times (χ(2) = 12.920, P = 0.002), Eastern Cooperative Oncology Group (ECOG) score (χ(2) = 28.660, P = 0.000) and targeted drug usage (χ(2) = 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Jia-Yan
authors.initials: JY
authors.lastname: Ni
authors.affiliation: 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.
authors.forename: Hong-Liang
authors.initials: HL
authors.lastname: Sun
authors.affiliation: 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.
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: 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.
authors.forename: Jiang-Hong
authors.initials: JH
authors.lastname: Luo
authors.affiliation: 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.
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.affiliation: 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.
authors.forename: Xiong-Ying
authors.initials: XY
authors.lastname: Jiang
authors.affiliation: 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.
authors.forename: Lin-Feng
authors.initials: LF
authors.lastname: Xu
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D020246:Venous Thrombosis / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D055815:Young Adult
keywords: Hepatocellular carcinoma; Microwave ablation; Prognosis; Survival; Transarterial chemoembolization