Preoperative Hepatic Arterial Blood Supply Coefficient and Portal Vein Blood Supply Coefficient to Predict Survival Prognosis after Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma

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.