Hepatocellular carcinoma in extremely elderly patients: An analysis of clinical characteristics, prognosis and patient survival

被引:50
作者
Tsukioka, Gengo
Kakizaki, Satoru
Sohara, Naondo
Sato, Ken
Takagi, Hitoshi
Arai, Hirotaka
Abe, Takehiko
Toyoda, Mitsuo
Katakai, Kenji
Kojima, Akira
Yamazaki, Yuichi
Otsuka, Toshiyuki
Matsuzaki, Yutaka
Makita, Fujio
Kanda, Daisuke
Horiuchi, Katsuhiko
Hamada, Tetsuya
Kaneko, Mieko
Suzuki, Hideyuki
Mori, Masatomo
机构
[1] Gunma Univ, Grad Sch Med, Dept Med & Mol Sci, Gunma 3718511, Japan
[2] Maebashi Red Cross Hosp, Dept Gastroenterol, Gunma 3710014, Japan
[3] Isesaki City Hosp, Dept Internal Med, Gunma 3720817, Japan
[4] Kiryu Kousei Gen Hosp, Dept Internal Med, Gunma 3760024, Japan
[5] Tone Chuo Hosp, Dept Internal Med, Gunma 3780053, Japan
[6] Natl Nishigunma Hosp, Dept Gastroenterol, Gunma 3770027, Japan
[7] Saiseikai Maebashi Hosp, Dept Gastroenterol, Gunma 3710821, Japan
[8] Publ Tomioka Gen Hosp, Dept Gastroenterol, Gunma 3702361, Japan
[9] Hlth Insurance Soc Gen Ota Hosp, Fuji Heavy Ind Ltd, Gunma 3730056, Japan
[10] Shimada Mem Hosp, Dept Gastroenterol, Gunma 3750024, Japan
关键词
hepatocellular carcinoma; extremely elderly patients; survival analysis; cause of death;
D O I
10.3748/wjg.v12.i1.48
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To identify the clinical and prognostic features of patients with hepatocellular carcinoma (HCC) aged 80 years or more. METHODS: A total of 1310 patients with HCC were included in this study. Ninety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged >= 50 years but less than 60 years were regarded as the non-elderly group. RESULTS: The sex ratio (male to female) was significantly lower in the extremely elderly group (0.90:1) than in the non-elderly group (3.9:1, P < 0.001). The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group (P < 0.001). There were no significant differences in the following parameters: diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment (P < 0.001) and they were more likely to receive conservative treatment (P < 0.01). There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage I/II, stage I/II and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liver-related diseases even in the extremely elderly patients. CONCLUSION: In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients. (C) 2006 The WJG Press. All rights reserved.
引用
收藏
页码:48 / 53
页数:6
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