Abstract
BACKGROUND AND AIM: Drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) is commonly used to treat unresectable hepatitis B-related primary liver cancer, but its therapeutic effect is influenced by various factors. This study analyzes the clinical factors related to the overall survival (OS) and progression-free survival (PFS) of patients with hepatitis B-related hepatocellular carcinoma (HCC) treated with DEB-TACE to provide reference data for individualized treatment. METHODS: In this retrospective study, 128 patients with hepatitis B-related primary liver cancer who received DEB-TACE treatment and being followed up (range of follow-up: 4-39 months) were included. The relationships between clinical characteristics, tumor markers, inflammatory factors, blood biochemical parameters, and OS and PFS were analyzed. Statistical methods, including Kaplan-Meier analysis, the Log rank test, and Cox regression analysis, were used to evaluate independent factors affecting patient prognosis. RESULTS: Factors such as tumor size, tumor number, vascular invasion, extrahepatic metastasis, stage (CNLC and BCLC), and alpha-fetoprotein (AFP) level significantly affected OS and PFS (P < 0.05). In particular, patients with a tumor diameter >5 cm, multiple tumors, portal vein invasion, and extrahepatic metastasis had significantly shorter OS and PFS. Preoperative inflammatory factors (eg, white blood cell count, absolute neutrophil count, procalcitonin, and C-reactive protein) and blood biochemical parameters (eg, aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB)) were closely related to patient prognosis. Multivariate Cox regression analysis revealed that age, Child-Pugh score, BCLC stage, TBIL, ALB, CRP, and AFP were independent prognostic factors for OS. CONCLUSION: This study highlights the significance of tumor clinical characteristics and preoperative inflammatory factors in predicting the prognosis of patients with hepatitis B-related HCC treated with DEB-TACE. By comprehensively evaluating these clinical and biological markers, more personalized treatment plans can be developed for liver cancer patients, thereby improving treatment outcomes and survival rates.