Zhang Qiyu, Liang Qiongyu, Xu Chi
Department of Interventional Treatment, Beijing NO.6 Hospital, No. 36, North Ertiao, Jiaodaokou, Dongcheng District, Beijing, 100009, China.
Discov Oncol. 2025 May 7;16(1):682. doi: 10.1007/s12672-025-02490-7.
BACKGROUND/AIM: Hepatic carcinoma, including hepatocellular carcinoma (HCC), is one of the most common malignant tumors globally, with an increasing incidence among younger populations. While chemotherapy is effective for advanced HCC, its impact on the prognosis of younger patients, who typically have better physiological conditions, remains unclear. Younger patients may have different tumor biology and chemotherapy responses than older patients. This study aims to evaluate the impact of chemotherapy on the prognosis and survival rates of younger HCC patients.
A retrospective analysis was conducted using the Surveillance, Epidemiology, and End Results Program (SEER) database, which provides information on cancer statistics among the US population. We selected patients diagnosed with primary HCC between 2010 and 2015. The patients were divided into two groups based on whether they received chemotherapy or not. Kaplan-Meier analyses were utilised to evaluate the impact of chemotherapy on prognosis by comparing the overall survival (OS) and cancer-specific survival (CSS) between the two groups. After performing 1:1 propensity score matching (PSM), the differences in OS and CSS were reassessed.
Before PSM, there were 1662 participants with primary HCC. After PSM, the sample was reduced to 1154 participants, with 577 individuals in each chemotherapy and non-chemotherapy group. Before PSM, there was no statistically significant difference in OS and CSS between the chemotherapy and non-chemotherapy groups (P = 0.25 and P = 0.06). After PSM, although the survival time in the chemotherapy group was slightly extended, the difference remained statistically insignificant (P = 0.09 and P = 0.38). Kaplan-Meier curves indicated no significant difference between the chemotherapy and non-chemotherapy groups, both before and after PSM, further supporting the conclusion that chemotherapy did not significantly improve survival in young patients with HCC.
Chemotherapy did not significantly improve survival for young patients with HCC. Treatment decisions should be approached cautiously, especially in cases with complex tumor characteristics. Future studies should explore the mechanisms of chemotherapy in younger patients and develop personalized treatment strategies to improve long-term outcomes.
背景/目的：肝癌，包括肝细胞癌（HCC），是全球最常见的恶性肿瘤之一，在年轻人群中的发病率呈上升趋势。虽然化疗对晚期HCC有效，但其对通常生理状况较好的年轻患者预后的影响尚不清楚。年轻患者可能与老年患者具有不同的肿瘤生物学特性和化疗反应。本研究旨在评估化疗对年轻HCC患者预后和生存率的影响。
使用监测、流行病学和最终结果计划（SEER）数据库进行回顾性分析，该数据库提供美国人群癌症统计信息。我们选取了2010年至2015年期间诊断为原发性HCC的患者。根据是否接受化疗将患者分为两组。采用Kaplan-Meier分析方法，通过比较两组的总生存期（OS）和癌症特异性生存期（CSS）来评估化疗对预后的影响。在进行1:1倾向评分匹配（PSM）后，重新评估OS和CSS的差异。
在PSM之前，有1662名原发性HCC参与者。PSM后，样本减少至1154名参与者，化疗组和非化疗组各有577人。在PSM之前，化疗组和非化疗组的OS和CSS无统计学显著差异（P = 0.25和P = 0.06）。PSM后，虽然化疗组的生存时间略有延长，但差异仍无统计学意义（P = 0.09和P = 0.38）。Kaplan-Meier曲线表明，在PSM前后，化疗组和非化疗组之间均无显著差异，进一步支持了化疗未显著改善年轻HCC患者生存率的结论。
化疗未显著改善年轻HCC患者的生存率。治疗决策应谨慎做出，尤其是在肿瘤特征复杂的情况下。未来的研究应探索化疗在年轻患者中的作用机制，并制定个性化治疗策略以改善长期预后。
