Xiao Jun, Li Guojian, Lin Shuhan, He Ke, Lai Hao, Mo Xianwei, Chen Jiansi, Lin Yuan
Department of Gastrointestinal Surgery, Tumor Hospital of Guangxi Medical University Nanning 530021, Guangxi Autonomous Region, China.
Provincial Departments of Health Nanning 530021, Guangxi Autonomous Region, China.
Int J Clin Exp Pathol. 2014 Feb 15;7(3):1114-23. eCollection 2014.
We aim to investigate the clinical characteristics and prognostic factors of Hepatocellular Carcinoma (HCC) patients treated by transarterial chemoembolization (TACE) in Chinese cohort. A total of 2,493 HCC patients treated by TACE were included in this retrospective study. Patients were divided into the younger group (n=1,877) or the elderly group (n=616) based upon their ages (cut-off value of 60 y/o). Chi-square test or Wilcoxon rank-sum test was used to compare patients' characteristics. Univariate and multivariate analysis were used to determine prognostic factors. When compared with the younger group, the elderly group had lower male/female ratio and family liver disease history ratio, as well as advanced stage or Child-Pugh grade B patients. The median survival time was 8 months and 27 months for the younger and the elderly group, respectively. The 1-, 2-, and 3-year survival rates in the younger group and the elderly group were 31.82%, 12.5%, 6.53%, and 84.66%, 53.28%, 28.39%, respectively. Multivariate analysis showed that HBV infection, AFP value, TNM stage, Child-Pugh class, portal vein tumor thrombus (PVTT) and tumor number were independent prognostic factors for the younger patients; the elderly ones had similar independent prognostic factors except for HBV infection. The elderly group had lower male/female ratio and family history ratio, as well as advanced stage or Child-Pugh grade B patients. The elderly seems to have better prognosis than the younger ones, which is probably related to the fact that the elderly have lower tumor burden and better liver function.
我们旨在研究中国队列中经动脉化疗栓塞术（TACE）治疗的肝细胞癌（HCC）患者的临床特征和预后因素。本回顾性研究纳入了2493例接受TACE治疗的HCC患者。根据年龄（临界值60岁）将患者分为较年轻组（n = 1877）或老年组（n = 616）。采用卡方检验或Wilcoxon秩和检验比较患者特征。采用单因素和多因素分析确定预后因素。与较年轻组相比，老年组的男女比例和家族肝病病史比例较低，晚期或Child-Pugh B级患者较多。较年轻组和老年组的中位生存时间分别为8个月和27个月。较年轻组和老年组的1年、2年和3年生存率分别为31.82%、12.5%、6.53%和84.66%、53.28%、28.39%。多因素分析显示，HBV感染、AFP值、TNM分期、Child-Pugh分级、门静脉癌栓（PVTT）和肿瘤数量是较年轻患者的独立预后因素；老年患者除HBV感染外有类似的独立预后因素。老年组的男女比例和家族病史比例较低，晚期或Child-Pugh B级患者较多。老年患者的预后似乎优于较年轻患者，这可能与老年患者肿瘤负荷较低和肝功能较好有关。
