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Clinical study of transcatheter arterial chemoembolization in treatment of primary hepatic carcinoma combined with hepatic arteriovenous shunt (HAVS)
Pages: 529-532
Year: Issue:  5
Journal: Radiologic Practice

Abstract: Objective:To investigate the effect of transcatheter arterial chemoembolization (TACE) in primary hepatic carcinoma combined with hepatic arteriovenous shunt (HAVF) and factors influencing the prognosis.Methods:From November 2013 to January 2015,67 patients with inoperable primary hepatic carcinoma combined with hepatic arteriovenous shunt were treated by TACE.The effect of chemo-embolization on arterioportal shunt,the short-term effect and long-term effect were observed.Kaplan-Meier method,the cumulative survival rates and multivariate Cox proportional hazard model were used to analyze the survival prognostic factors.Results:Of a total of 67 cases of HAVS,there were 59 cases of hepatic arterioportal shunt and 8 eases of hepatic arteriovenous shunt respectively.53 cases were mild-to-moderate shunt and 14 cases were severe shunt.44 cases of HAVF were completely occluded,and the embolization rate of mild-to-moderate shunt was significantly better than that of severe shunt (x2 =7.04,P =0.008).Complete remission,partial remission,stable disease and progressive disease were obtained in 2,29,30 and 6,respectively.The overall effective rate was 46.7%.The 1-year survival rate and median survival time were 49.3% and 11.0 months respectively.Log-rank analysis showed that tumor size,tumor thrombosis,preoperative AFP level,the type of lipiodol retention and the effect of embolization on HAVS were the factors affecting prognosis.Multivariable analysis showed that tumor size and the type of lipiodol retention were the independent prognostic factors of survival rate.Conclusion:Transcatheter arterial chemoembolization is an effective method of treatment in primary hepatic carcinoma combined with HAVS.Tumor size and the type of lipiodol retention are the independent prognostic factors.
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