Objective:To investigate the clinical value of ribs removal for treating middle-late stage primary liver cancer using high intensity focused ultrasound(HIFU)plus transcatheter arterial chemoembolization(TACE).Methods:68 middle-late stage patients with primary liver cancer were divided into ribs removal group(36 patents with 43 tumors)and non-ribs removal group(32 patients with 40 tumors).All patients received TACE and HIFU sequentially.Follow up the patients’survival and tumorablation results after TACE and HIFU.The median time

survival rates of 1-year and2-year

the rates of complete ablation and larger than 80%ablation volume were compared between two groups.Results:The average follow-up time of all patients were 11.9±11.4 months.The median time

1-year and 2-year survival rates in ribs removal group and non-ribs removal group were 13 months

52.3%

21.8%and 12months

46.8%

17.6%respectively.There was no significant difference of the survival between two group(sP=0.8155

log-rank tes)t.The rates of complete ablation and larger than 80%ablation volume in two groups were 46.5%

79.1%and 37.5%

67.5%respectively.There were no significant difference of the rates between two group(sP>0.05

Chi-square test).Conclusion:Ribs removal can not improve the effects of HIFU plus TACE in the treatment of middle-late stage primary liver cancer significantly.