Preoperative Hepatic Arterial Blood Supply Coefficient and Portal Vein
Blood Supply Coefficient to Predict Survival Prognosis after
Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma
Abstract
Objective The objective of this study is to examine the relationship
between Preoperative hepatic arterial blood supply coefficient (HAC) and
portal vein blood supply coefficient (PVC), and their impact on
progression-free survival (PFS) and overall survival (OS) following
transcatheter arterial chemoembolization (TACE) for hepatocellular
carcinoma (HCC). Methods A retrospective analysis was carried out on 113
patients who were diagnosed with HCC in our hospital and received TACE
treatment. Furthermore, the perfusion-enhanced CT prior to the first
TACE in each patient selected the tumor area from plain scan, arterial
late stage, as well as the portal venous stage to measure the average CT
value and calculate HAC and PVC. All patients received follow-up care
through August 2022. Besides, the independent predictors of PFS and OS
were acquired by COX regression analysis, and subsequently, the
independent predictors and the correlation between PFS and OS were
evaluated by the Log-rank test, and the survival curve was drawn by
Kaplan-Meier. Results A total of 91 patients died, with a mortality rate
of 80.5%, the median progression-free survival was 0.78 (0.23-2.13)
years, and the median overall survival was 2.04 (1.22-3.98) years.
Univariate and multivariate COX regression analysis demonstrated that
HAC and vascular invasion were independent predictors of PFS and OS
(P<0.05). By utilizing the optimal HAC cut-off value, HAC was
divided into low HAC and high HAC groups, and the liver function grade
and largest tumor diameter were statistically distinct between the two
groups (both P<0.05). Conclusion Preoperative HAC and vascular
invasion predict progression-free survival as well as overall survival
after TACE of hepatocellular carcinoma. Furthermore, HCC with HAC ≥
0.042 and preoperative vascular invasion by now demonstrated on imaging
are particularly susceptible to progression after TACE and have a
shorter overall survival time.