目的

探讨老年性原发性肝癌患者肝切除术的治疗效果和围手术期特点。

方法

1972 年1 月至2003 年5 月，共对1711 例原发性肝癌患者行肝切除术，其中年龄≥70 岁的患者43例（老年组）；随机抽取同期年龄<70 岁的患者57 例作为对照组。比较两组患者肝切除术的疗效和临床病理特点。

结果

与对照组患者相比，老年肝癌患者HBV 感染率、AFP 阳性率低，术前伴发病较多，肿瘤包膜阳性率及术后1 年总生存率较高；而两组患者的性别构成、临床症状、HCV 感染率、术前肝肾功能、肝硬化、卫星病灶、癌栓、术前肿瘤破裂、术中失血量、根治性切除率、术后并发症发生率、术后无瘤生存率等方面均无显著差异。

结论

肝切除术治疗老年原发性肝癌患者是安全的，对无术前伴发病或术前已有效控制伴发病的老年原发性肝癌患者，肝切除术是治疗的首选方案。

Objective

To evaluate the curative effect of hepatic for elderly patients with primary resection liver cancer (PLC).

Methods

1711 patients with PLC received hepatic resection in the Cancer Center of Sun Yat-Sen University. Forty-three elderly patients (≥70 years of age) with PLC and 57 patients in control group selected randomly from 1668 patients (<70 years of age) with PLC treated in the same period were studied retrospectively， The clinicopathological and laboratory data of the 100 patients were analyzed.

Results

The elderly PLC patients had lower HBsAg-positive rate and AFP-positive rate，more complications before operation，higher rate of tumor capsule formation and higher 1-year post-operation survival rate; while there were no statistically significant differences between the two groups in other factors(including sex ratio， positive symptom， HCV-positive rate， liver function， renal function， accompanying cirrhosis， satellite lesions， tumor rupture， blood loss， resection rate， post operation complication and diseasefree survival rate).

Conclusion

Hepatic resection for elderly patients with PLC has a similar curative effect compared with control group. For the elderly patients without complications or with controlled complications，hepatic resection is a safe and effective treatment.