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评估80岁以上肝细胞癌患者肝切除的临床病理特征的可行性。

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age.

作者信息

Iida Hiroya, Kaibori Masaki, Matsui Kosuke, Ishizaki Morihiko, Kon Masanori

机构信息

Department of Surgery, Kansai Medical University, Osaka 573-1010, Japan.

出版信息

Mol Clin Oncol. 2017 Jan;6(1):29-38. doi: 10.3892/mco.2016.1079. Epub 2016 Nov 11.

Abstract

The aim of the present study was to evaluate the clinicopathological features, benefits and problems associated with hepatic resection of hepatocellular carcinoma in patients aged ≥80 years. Between 2006 and 2013, hepatic resection was performed in 395 hepatocellular carcinoma patients, including 351 patients aged <80 years and 44 patients aged ≥80 years. Clinicopathological examination revealed that the tumor size was significantly larger among patients of ≥80 years of age. However, recurrence-free and cumulative survival rates were similar between the two age groups. The occurrence of post-operative complications was an independent risk factor for survival among patients ≥80 years of age. In addition, the albumin level was identified as a risk factor for post-operative complications. The post-operative transition towards an improvement in the albumin level in the ≥80 years group was significantly lower compared with the <80 years group. It was revealed that hepatic resection was feasible for elderly patients. However, the post-operative improvement in the albumin levels was less marked among patients ≥80 years of age, and lower albumin levels were associated with post-operative complications and prognosis. Therefore, elderly patients undergoing hepatic resection should receive peri-operative management including special nutrition.

摘要

本研究的目的是评估年龄≥80岁的肝细胞癌患者肝切除的临床病理特征、益处及相关问题。2006年至2013年期间,对395例肝细胞癌患者实施了肝切除术,其中包括351例年龄<80岁的患者和44例年龄≥80岁的患者。临床病理检查显示,≥80岁患者的肿瘤尺寸明显更大。然而,两个年龄组的无复发生存率和累积生存率相似。术后并发症的发生是≥80岁患者生存的独立危险因素。此外,白蛋白水平被确定为术后并发症的一个危险因素。与<80岁组相比,≥80岁组术后白蛋白水平改善的转变明显更低。结果显示肝切除术对老年患者是可行的。然而,≥80岁患者术后白蛋白水平的改善不太明显,较低的白蛋白水平与术后并发症及预后相关。因此,接受肝切除术的老年患者应接受包括特殊营养在内的围手术期管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9fd/5245114/43e00470160d/mco-06-01-0029-g00.jpg

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