Wang Yaxi, Cheng Zhigang, Yu Jie, Li Xin, Hao Guoliang, Liu Fangyi, Han Zhiyu, Yu Xiaoling, Liang Ping
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing; Department of Ultrasound, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China.
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
J Cancer Res Ther. 2020;16(2):292-300. doi: 10.4103/jcrt.JCRT_1021_19.
To compare the overall survival (OS), disease-free survival (DFS) and liver-cancer-specific survival (LCSS) of elderly (≥65 years) and younger patients (< 65 years) with early-stage hepatocellular carcinoma (HCC) using ultrasound-guided percutaneous microwave ablation (US-PMMA).
From January 2002 to December 2017, 510 elderly and 1053 younger patients were diagnosed with early-stage HCC according to the Milan criteria. All of these patients were treatment-naïve to US-PMMA. Baseline characteristics were collected to identify any risk factors to determine the survival outcomes. OS, DFS, and LCSS probabilities were calculated with the Kaplan-Meier method and compared using the Log-rank test.
Complete ablation was achieved in all patients. Elderly patients were more likely to be, hepatitis C virus infection, comorbidities, cirrhosis, larger tumors, poor liver functional reservation, more ablation points, longer ablation time, longer hospital stays, and higher hospitalization costs (P < 0.05). Over the follow-up period (12-156 months), no significant differences were detected in OS, DFS, and LCSS between the two groups ( P = 0.092, 0.318, and 0.183). r-GT, ALB and ablation session were significant factors for OS, r-GT and ALB for LCSS, and cirrhosis, tumor number, AFP and ablation points for RFS in the multivariate analysis, respectively. No treatment-related deaths occurred in the two groups. Any complications were treated as appropriate.
Although advanced age and comorbidities are intrinsic factors in elderly HCC patients, similar survival outcomes were obtained in elderly and younger HCC patients treated by US-PMWA, despite elderly patients having more comorbidities.
比较老年（≥65岁）和年轻患者（<65岁）早期肝细胞癌（HCC）接受超声引导下经皮微波消融（US-PMMA）后的总生存期（OS）、无病生存期（DFS）和肝癌特异性生存期（LCSS）。
2002年1月至2017年12月，根据米兰标准诊断出510例老年和1053例年轻早期HCC患者。所有这些患者均未接受过US-PMMA治疗。收集基线特征以识别任何风险因素，从而确定生存结果。采用Kaplan-Meier方法计算OS、DFS和LCSS概率，并使用对数秩检验进行比较。
所有患者均实现完全消融。老年患者更易出现丙型肝炎病毒感染、合并症、肝硬化、肿瘤较大、肝功能储备差、消融点数更多、消融时间更长、住院时间更长以及住院费用更高（P<0.05）。在随访期（12 - 156个月）内，两组之间的OS、DFS和LCSS未检测到显著差异（P = 0.092、0.318和0.183）。多因素分析中，r-GT、ALB和消融次数分别是OS的显著因素，r-GT和ALB是LCSS的显著因素，而肝硬化、肿瘤数量、AFP和消融点数是RFS的显著因素。两组均未发生与治疗相关的死亡。对任何并发症进行了适当处理。
尽管高龄和合并症是老年HCC患者的内在因素，但接受US-PMWA治疗的老年和年轻HCC患者获得了相似的生存结果，尽管老年患者合并症更多。
