Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Eur J Surg Oncol. 2014 Feb;40(2):214-9. doi: 10.1016/j.ejso.2013.10.016. Epub 2013 Nov 5.
The role of surgery in the management of large hepatocellular carcinomas (HCCs) is controversial. Advanced age and comorbidities are taken into account when major surgery is considered.
To compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) for resectable HCC in patients aged 70 years or older.
This study included 70 patients aged 70 years or older treated for large HCCs (≥5 cm) between January 2007 and December 2012: 37 underwent LR and 33 underwent TACE. The outcomes of these patients were retrospectively analyzed. Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated, and survival data were compared using the log-rank test.
Hospital stay was significantly longer in the LR group than in the TACE group (10 days vs 8.5 days; P = 0.003). Treatment-related complications were more frequent in the TACE group, but this difference was not statistically significant. LR was associated with a better disease-free survival rate, median survival rate and cumulative overall survival rate.
Our results showed that LR could be a safe and effective treatment option for HCC tumors ≥5 cm in patiets aged 70 years or older.
手术在大肝细胞癌（HCC）治疗中的作用存在争议。在考虑进行大手术时，会考虑到高龄和合并症。
比较肝切除术（LR）和经动脉化疗栓塞术（TACE）治疗 70 岁及以上可切除 HCC 的效果。
本研究纳入 2007 年 1 月至 2012 年 12 月期间治疗的 70 名 70 岁及以上的大 HCC（≥5cm）患者：37 例行 LR，33 例行 TACE。回顾性分析这些患者的结局。建立单变量和多变量 Cox 比例风险模型。生成 Kaplan-Meier 生存曲线，并使用对数秩检验比较生存数据。
LR 组的住院时间明显长于 TACE 组（10 天 vs 8.5 天；P = 0.003）。TACE 组治疗相关并发症更常见，但差异无统计学意义。LR 与更好的无病生存率、中位生存率和累积总生存率相关。
我们的结果表明，LR 可能是 70 岁及以上 HCC 肿瘤≥5cm 患者的安全有效的治疗选择。
