Center of Integrative Medicine, Capital Medical University Affiliated Beijing Ditan Hospital, No. 8 Jing Shun East Street, Beijing, 100015, People's Republic of China.
Dongzhimen Hospital, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 100029, People's Republic of China.
BMC Cancer. 2022 Feb 18;22(1):185. doi: 10.1186/s12885-022-09293-x.
The number of young patients with hepatocellular carcinoma (HCC) is increasing, but whether patients of different ages have a survival advantage is unclear. This study was conducted to investigate whether age differences in the Barcelona Clinic Liver Cancer (BCLC) classification system contribute to the long-term survival outcomes of patients with HCC.
A total of 1602 patients with HCC admitted to the Beijing Ditan Hospital was included in this study. Patients were divided into younger (≤45 years) and older (> 45 years) groups. Factors determining overall survival and progression-free survival were analyzed using univariate and multivariate analyses with the Kaplan-Meier method and Cox proportional hazard regression model. We calculated the cumulative incidence function using the Fine-Gray model. The effect of mortality on age was also estimated using a restricted cubic spline.
After matching, overall survival and progression-free survival were significantly better in younger patients than in older patients with BCLC stage 0-B (p = 0.015 and p = 0.017, respectively). In BCLC stage 0-B, all-cause mortality increased with age and increased rapidly around the age of 40 years (non-linear, p < 0.05). In BCLC stages 0-B, HCC-related and non-HCC-related deaths significantly differed between younger and older individuals (p = 0.0019).
In stage BCLC 0-B, age affects the long-term prognosis of patients.
患有肝细胞癌（HCC）的年轻患者人数正在增加，但不同年龄段的患者是否具有生存优势尚不清楚。本研究旨在探讨巴塞罗那临床肝癌（BCLC）分期系统中的年龄差异是否有助于 HCC 患者的长期生存结局。
本研究共纳入 1602 例在北京地坛医院就诊的 HCC 患者。将患者分为年轻（≤45 岁）和年老（>45 岁）两组。采用 Kaplan-Meier 方法和 Cox 比例风险回归模型对总生存期和无进展生存期的影响因素进行单因素和多因素分析。采用 Fine-Gray 模型计算累积发病率函数。采用限制性立方样条估计死亡率对年龄的影响。
匹配后，BCLC 分期 0-B 的年轻患者的总生存期和无进展生存期明显优于老年患者（p=0.015 和 p=0.017）。在 BCLC 分期 0-B 中，全因死亡率随年龄增长而增加，且在 40 岁左右迅速增加（非线性，p<0.05）。在 BCLC 分期 0-B 中，年轻和老年个体的 HCC 相关和非 HCC 相关死亡有显著差异（p=0.0019）。
在 BCLC 分期 0-B 中，年龄影响患者的长期预后。
