80 岁以上老年人肝细胞癌肝切除术的结果。

Outcomes of liver resection for hepatocellular carcinoma in octogenarians.

机构信息

Department of HPB and Transplant Surgery, St. James's University Hospital NHS Trust, Leeds, LS9 7TF, UK.

出版信息

HPB (Oxford). 2020 Sep;22(9):1324-1329. doi: 10.1016/j.hpb.2020.01.006. Epub 2020 Feb 1.

DOI:10.1016/j.hpb.2020.01.006

PMID:32019739

Abstract

BACKGROUND

There is a dearth of information about operative outcomes in patients ≥80 years for hepatocellular carcinoma (HCC) from Western institutions. We compare the result of HCC resections in patients <80 years vs. patients ≥80 years from our institution in the UK.

METHODS

We conducted a retrospective review of all patients undergoing liver resections for HCC between 2005 and 2015. Demographics, comorbidities, morbidity, mortality and survival were compared between the two age groups.

RESULTS

200 patients underwent resection for HCC in this time period. Nineteen patients were ≥80 years and 181 were <80 years. Comorbidities measured by the Charlson Comorbidity Index were significantly higher in the ≥80 group (p < 0.0001). There was no significant difference in the extent of resection in the two groups. Morbidity and mortality between the <80 years and the ≥80 years group were not significantly different (morbidity 27% vs.16%; p = 0.29) (mortality 7% vs. 0%; p = 0.11). The one-year (83.4% vs. 88.2%; p = 0.83), five-year (56.3% vs. 55.8%; p = 0.83) and the overall survival rate rates (887 days vs. 1035 days; p = 0.66) were not significantly different between the groups.

DISCUSSION

Liver resection should not be precluded based on age alone; with good outcomes in patients ≥80 years justifying surgery.

摘要

背景

来自西方医疗机构的信息表明，80 岁以上的肝细胞癌 (HCC) 患者的手术结果很少。我们比较了英国机构中 80 岁以下和 80 岁以上患者的 HCC 切除术结果。

方法

我们对 2005 年至 2015 年间所有接受 HCC 肝切除术的患者进行了回顾性分析。比较了两组患者的人口统计学、合并症、发病率、死亡率和生存率。

结果

在此期间，有 200 名患者接受了 HCC 切除术。其中 19 名患者年龄≥80 岁，181 名患者年龄<80 岁。≥80 岁组的 Charlson 合并症指数测量的合并症明显更高（p<0.0001）。两组的切除范围无显著差异。<80 岁组和≥80 岁组之间的发病率和死亡率无显著差异（发病率 27%比 16%；p=0.29）（死亡率 7%比 0%；p=0.11）。两组患者的 1 年（83.4%比 88.2%；p=0.83）、5 年（56.3%比 55.8%；p=0.83）和总生存率（887 天比 1035 天；p=0.66）无显著差异。