Department of Gastroenterology, Ehime University Graduate School of Medicine, Ehime, Japan.
J Gastroenterol Hepatol. 2010 Feb;25(2):403-7. doi: 10.1111/j.1440-1746.2009.06037.x. Epub 2009 Nov 19.
With the aging of society, the number of elderly patients with hepatocellular carcinoma (HCC) has been increasing in Japan. The Government of Japan defines elderly as being over 65 and has divided the elderly into two stages: the first elderly stage (< 75 years old) and the second elderly stage (> or = 75). We investigated the efficacy and safety of radiofrequency ablation therapy (RFA) in patients in the second elderly stage in comparison with other HCC patients, retrospectively.
Two hundred six patients with HCC, who were within the Milan criteria, with low-grade performance status (0 or 1) and a Child-Pugh classification of A or B were enrolled. All were treated with RFA from January 2000 to December 2008 as an initial therapy and were divided into elderly HCC group (e-HCC group; > or = 75, n = 63) and non e-HCC group (< 75, n = 143), and their clinical data and survival rates were compared.
Age and the level of protein induced by vitamin K absence or antagonist (PIVKA-II) were higher in the e-HCC group as compared with the non e-HCC group (78.3 +/- 3.2 vs 64.2 +/- 7.5 years, 676.3 +/- 2643.7 vs 142.4 +/- 442.2 mAU/mL: P < 0.01, respectively). There were no significant differences for Child-Pugh class, tumor node metastasis stage, and Japan Integrated Stage score and in survival rates after 3, and 5 years between the groups (e-HCC group: 82.5% and 49.7%, respectively; non e-HCC group: 78.3% and 57.5%, respectively). There were no severe complications in the e-HCC group.
Elderly HCC patients, who have good performance status, should be treated in the same manner and with the same strategy as young HCC patients.
随着社会老龄化，日本老年肝癌（HCC）患者的数量不断增加。日本政府将老年人定义为 65 岁以上，并将老年人分为两个阶段：第一老年阶段（<75 岁）和第二老年阶段（≥75 岁）。我们回顾性地比较了第二老年阶段患者与其他 HCC 患者接受射频消融治疗（RFA）的疗效和安全性。
206 例符合米兰标准、低分级体能状态（0 或 1）和 Child-Pugh 分级 A 或 B 的 HCC 患者于 2000 年 1 月至 2008 年 12 月接受 RFA 作为初始治疗，根据年龄分为老年 HCC 组（e-HCC 组；≥75 岁，n=63）和非老年 HCC 组（<75 岁，n=143），比较两组患者的临床资料和生存率。
与非老年 HCC 组相比，老年 HCC 组的年龄和维生素 K 拮抗剂诱导蛋白（PIVKA-II）水平更高（78.3±3.2 岁比 64.2±7.5 岁，676.3±2643.7 mAU/mL 比 142.4±442.2 mAU/mL：P<0.01）。两组患者的 Child-Pugh 分级、肿瘤淋巴结转移分期和日本综合分期评分以及 3 年和 5 年生存率无显著差异（老年 HCC 组分别为 82.5%和 49.7%，非老年 HCC 组分别为 78.3%和 57.5%）。老年 HCC 组无严重并发症。
体能状态良好的老年 HCC 患者应采用与年轻 HCC 患者相同的方式和策略进行治疗。
