Mori Shozo, Kita Junji, Shimizu Takayuki, Kato Masato, Shimoda Mitsugi, Kubota Keiichi
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
Int Surg. 2014 Mar-Apr;99(2):153-60. doi: 10.9738/INTSURG-D-13-00213.1.
The outcome of liver resection (LR) for elderly hepatocellular carcinoma (HCC) patients with portal hypertension (PHT) who may be excluded as liver transplantation candidates has not been fully evaluated. One hundred ninety-five patients who underwent initial curative LR for HCC with PHT were divided into 2 groups: age <70 years (n = 131) and age ≥70 years (n = 64). Clinicopathologic data and postoperative complications were compared. Preoperative characteristics and postoperative complications were similar in both groups. However, in-hospital mortality was significantly more frequent in elderly than in younger patients (11% versus 1%, P = 0.002). No significant intergroup differences were observed in the 5-year disease-free survival rate or recurrence rate (19.7% versus 17.2%; P = 0.338, 63% versus 56%; P = 0.339). Although LR for elderly HCC patients with PHT can be performed with curative intent and gives results comparable with those in younger patients, it is associated with higher in-hospital mortality.
对于那些可能因门静脉高压（PHT）而被排除在肝移植候选名单之外的老年肝细胞癌（HCC）患者，肝切除术（LR）的疗效尚未得到充分评估。195例因HCC合并PHT而接受初次根治性LR的患者被分为两组：年龄<70岁（n = 131）和年龄≥70岁（n = 64）。比较了两组的临床病理数据和术后并发症。两组患者的术前特征和术后并发症相似。然而，老年患者的院内死亡率明显高于年轻患者（11% 对1%，P = 0.002）。在5年无病生存率或复发率方面未观察到显著的组间差异（19.7% 对17.2%；P = 0.338，63% 对56%；P = 0.339）。虽然对合并PHT的老年HCC患者进行LR可以达到根治目的，且结果与年轻患者相当，但它与较高的院内死亡率相关。
