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
Abstract
BACKGROUND

Primary hepatic carcinoma (PHC) has an insidious onset and is usually diagnosed in the middle and late stages. Although transcatheter arterial chemoembolization (TACE) is the preferred option for treating middle- and advanced-stage PHC, it has limited efficacy in killing tumor cells and poor long-term efficacy. TACE plus percutaneous microwave coagulation therapy (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 marker levels and the prognosis of patients with advanced PHC.

AIM

To investigate the effect of PMCT + TACE on serum tumor markers and the prognosis of middle-late PHC.

METHODS

This retrospective study included 150 patients with middle-late PHC admitted to Zhongshan People’s Hospital between March 2018 and February 2021. Patients were divided into a single group (treated with TACE, n = 75) and a combined group (treated with TACE + PMCT, n = 75). Before and after treatment, the clinical efficacy and serum tumor marker levels [carbohydrate antigen 19-9 (CA19-9), alpha-fetoprotein (AFP), and carcinoembryonic antigen (CEA)] of both groups were observed. The 1-year survival rates and prognostic factors of the two groups were analyzed.

RESULTS

The combined group had 21 and 35 cases of complete remission (CR) and partial remission (PR), respectively. The single group had 13 and 25 cases of CR and PR, respectively. After 4 wk of treatment, the serum CA19-9, CEA, and AFP 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 of the combined group (80.00%) was higher than that of the single group (60.00%) (P < 0.05). The average survival time within 1 year in the combined group was 299.38 ± 61.13 d, longer than that in the single group (214.41 ± 72.97 d, P < 0.05). COX analysis revealed that tumor diameter, tumor number, and the treatment method were prognostic factors for patients with middle-late PHC (P < 0.05).

CONCLUSION

TACE + PMCT is effective in treating patients with mid-late PHC. It reduces the levels of tumor markers, prolongs survival, and improves prognosis.

Keywords: Middle-late primary hepatic carcinoma; Percutaneous microwave coagulation therapy; Transcatheter arterial chemoembolization; Effect; Tumor markers; Prognosis; Survival

Core Tip: Middle- and late-stage primary hepatic carcinoma (PHC) has reached a phase of comprehensive treatment. Compared to single interventional therapy, transcatheter arterial chemoembolization (TACE) plus percutaneous microwave coagulation therapy (PMCT) can effectively improve prognosis and prolong patient survival. This study reveals that TACE + PMCT in the management of patients with middle-late PHC enhances tumor marker levels and prolongs survival time. Furthermore, we identify tumor diameter, tumor number, and treatment method as pivotal factors influencing prognosis.