Namba Yosuke, Ohira Masahiro, Imaoka Yuki, Hamaoka Michinori, Hashimoto Masakazu, Onoe Takashi, Takei Daisuke, Oishi Koichi, Yamaguchi Megumi, Abe Tomoyuki, Tadokoro Takeshi, Fukuhara Sotaro, Oshita Ko, Matsubara Keiso, Honmyo Naruhiko, Kuroda Shintaro, Tahara Hiroyuki, Kobayashi Tsuyoshi, Ide Kentaro, Ohdan Hideki
Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Department of Gastroenterological-Breast and Transplant Surgery Hiroshima Prefectural Hospital Hiroshima Japan.
Ann Gastroenterol Surg. 2024 Jun 22;9(1):169-177. doi: 10.1002/ags3.12838. eCollection 2025 Jan.
We previously reported that abdominal aortic calcification is associated with poor overall and recurrence-free survival after hepatectomy for hepatocellular carcinoma (HCC). However, the effect of abdominal aortic calcification on cancer-specific prognosis in very old patients with several comorbidities remains unknown. This multicenter study aimed to evaluate the impact of abdominal aortic calcification on the cumulative recurrence rate and recurrence-free survival in patients with HCC aged >80 years.
We retrospectively analyzed the data of 128 patients (aged ≥80 years) who underwent liver resection for hepatocellular carcinoma at seven hospitals belonging to Hiroshima Surgical Study Group of Clinical Oncology between January 2014 and December 2018. Patients were divided into two groups: high and low abdominal aortic calcification groups. The primary endpoints were cumulative recurrence rate and recurrence-free survival.
Kaplan-Meier survival curve analysis demonstrated that the cumulative recurrence rate in the high abdominal aortic calcification group was significantly higher than that in the low abdominal aortic calcification group, and the high abdominal aortic calcification group had a significantly lower recurrence-free survival rate. In the multivariate analysis, high abdominal aortic calcification ( = 0.03), high des-gamma-carboxyprothrombin score ( = 0.04), and multiple tumors ( < 0.01) were independent predictive factors for recurrent HCC, and high abdominal aortic calcification ( = 0.01) and high des-gamma-carboxyprothrombin ( = 0.01) were independent predictive factors for poor cancer-specific survival.
Our results indicate that the abdominal aortic calcification score is associated with cumulative recurrence rate and recurrence-free survival in very old patients with HCC.
我们之前报道过，腹主动脉钙化与肝细胞癌（HCC）肝切除术后的总体生存率及无复发生存率不佳相关。然而，腹主动脉钙化对患有多种合并症的高龄患者癌症特异性预后的影响尚不清楚。这项多中心研究旨在评估腹主动脉钙化对80岁以上HCC患者累积复发率和无复发生存率的影响。
我们回顾性分析了2014年1月至2018年12月期间在广岛临床肿瘤外科研究组所属的七家医院接受肝细胞癌肝切除术的128例患者（年龄≥80岁）的数据。患者被分为两组：高腹主动脉钙化组和低腹主动脉钙化组。主要终点是累积复发率和无复发生存率。
Kaplan-Meier生存曲线分析表明，高腹主动脉钙化组的累积复发率显著高于低腹主动脉钙化组，且高腹主动脉钙化组的无复发生存率显著更低。在多变量分析中，高腹主动脉钙化（=0.03）、高异常凝血酶原评分（=0.04）和多发肿瘤（<0.01）是HCC复发的独立预测因素，高腹主动脉钙化（=0.01）和高异常凝血酶原（=0.01）是癌症特异性生存不佳的独立预测因素。
我们的结果表明，腹主动脉钙化评分与高龄HCC患者累积复发率和无复发生存率相关。
