Hepatic resection for elderly patients with primary liver cancer

doi:10.3877/cma.j.issn.1674-0793.2007.03.011

Abstract

Abstract:

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.

Key words: Elderly, Primary liver cancer, Hepatectomy

Jun HUANG, Yun-Fei YUAN, Bin-Kui LI, Jin-Qing LI, Ya-Qi ZHANG, Guo-Hui LI. Hepatic resection for elderly patients with primary liver cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2007, 01(03): 159-162.

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https://zhptwkxwx.cma-cmc.com.cn/EN/Y2007/V01/I03/159

Figures/Tables 2

References 11

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	老年组(%)(43例)	对照组(%)(57例)	p
性别(男∶女)	38∶5	51∶6	0.256
临床症状发生率	21/39(53.8)	36/55(65.5)	0.862
术前合并症	16/43(37.2)	7/57(12.3)	0.003
Child-Pugh's Classification(A)级	41/43(95.3)	56/57(98.2)	0.401
HBsAg(+)	23/37(62.2)	41/45(91.1)	0.002
Anti-HCV Ab(+)	2/34(5.9)	1/41(2.4)	0.449
AFP≥25 n g/ml	15/37(40.5)	38/50(76.0)	0.001
术前Albumin(g/dl)	39.26±4.41	40.57±4.64	0.369
术前GGT(IU/L)	91.40±71.80	83.80±61.40	0.688
术前TBIL(μmol/L)	20.60±20.20	19.20±7.80	0.269
术前BUN(mmol/L)	6.31±2.64	6.75±8.14	0.152
术前CRE(μmol/L)	108.22±30.54	96.29±29.89	0.745
肝硬化阳性率	28/43(65.1)	42/55(76.4)	0.221
肿瘤大小(cm)	8.00±3.70	8.00±4.70	0.212
术前肿瘤破裂发生率	7/43(16.3)	13/57(22.8)	0.419
包膜阳性率	38/41(92.7)	38/53(71.7)	0.010
癌栓	4/43(9.3)	15/57(22.8)	0.131
卫星病灶阳性率	6/43(14.0)	15/57(26.3)	0.133
根治性切除率	34/43(79.1)	39/57(68.4)	0.235
术中出血量(ml)	391.50±399.50	497.1±628.5	0.278
术后并发症发生率	20/43(46.5%)	23/57(40.4%)	0.538

	老年组(%)(43例)	对照组(%)(57例)	p
性别(男∶女)	38∶5	51∶6	0.256
临床症状发生率	21/39(53.8)	36/55(65.5)	0.862
术前合并症	16/43(37.2)	7/57(12.3)	0.003
Child-Pugh's Classification(A)级	41/43(95.3)	56/57(98.2)	0.401
HBsAg(+)	23/37(62.2)	41/45(91.1)	0.002
Anti-HCV Ab(+)	2/34(5.9)	1/41(2.4)	0.449
AFP≥25 n g/ml	15/37(40.5)	38/50(76.0)	0.001
术前Albumin(g/dl)	39.26±4.41	40.57±4.64	0.369
术前GGT(IU/L)	91.40±71.80	83.80±61.40	0.688
术前TBIL(μmol/L)	20.60±20.20	19.20±7.80	0.269
术前BUN(mmol/L)	6.31±2.64	6.75±8.14	0.152
术前CRE(μmol/L)	108.22±30.54	96.29±29.89	0.745
肝硬化阳性率	28/43(65.1)	42/55(76.4)	0.221
肿瘤大小(cm)	8.00±3.70	8.00±4.70	0.212
术前肿瘤破裂发生率	7/43(16.3)	13/57(22.8)	0.419
包膜阳性率	38/41(92.7)	38/53(71.7)	0.010
癌栓	4/43(9.3)	15/57(22.8)	0.131
卫星病灶阳性率	6/43(14.0)	15/57(26.3)	0.133
根治性切除率	34/43(79.1)	39/57(68.4)	0.235
术中出血量(ml)	391.50±399.50	497.1±628.5	0.278
术后并发症发生率	20/43(46.5%)	23/57(40.4%)	0.538

组别	中位无瘤生存期(月)	中位生存期(月)	无瘤生存率			总体生存率
组别	中位无瘤生存期(月)	中位生存期(月)	1年	3年	5年	1年	3年	5年
老年组	9.1	36.8	43.3%	24.2%	12.1%	85.6%	53.3%	39.6%
对照组	14.7	24.0	51.3%	20.5%	7.7%	70.1%	52.1%	27.2%
P值			0.661	0.874	0.719	0.007^*	0.152	0.194

组别	中位无瘤生存期(月)	中位生存期(月)	无瘤生存率			总体生存率
组别	中位无瘤生存期(月)	中位生存期(月)	1年	3年	5年	1年	3年	5年
老年组	9.1	36.8	43.3%	24.2%	12.1%	85.6%	53.3%	39.6%
对照组	14.7	24.0	51.3%	20.5%	7.7%	70.1%	52.1%	27.2%
P值			0.661	0.874	0.719	0.007^*	0.152	0.194

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