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

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World Journal of Gastroenterology 2006年第1期12卷 48-53页

作者： Gengo Tsukioka Satoru Kakizaki Naondo Sohara Ken Sato Hitoshi Takagi Hirotaka Arai Takehiko Abe Mitsuo Toyoda Kenji Katakai Akira Kojima Yuichi Yamazaki Toshiyuki Otsuka Yutaka Matsuzaki fujio makita Daisuke Kanda Katsuhiko Horiuchi Tetsuya Hamada Mieko Kaneko Hideyuki Suzuki Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan Department of Gastroenterology Maebashi Red Cross HospitalMaebashiGunma 371-0014Japan Department of Internal Medicine Isesaki Municipal HospitalIsesakiGunma 372-0817Japan Department of Internal Medicine Kiryu Kousei General HospitalKiryuGunma 376-0024Japan Department of Internal Medicine Tone Chuo HospitalNuraataGunma 378-0053Japan Department of Gastroenterology National Nishigunma HospitalShibukawaGumna 377-0027Japan Department of Gastroenterology Saiseikai Maebashi HospitalMaebashiGunma 371-0821Japan Department of Gastroenterology Public Tomioka General HospitalTomiokaGunma 370-2361Japan Department of Internal Medicine Fuji Heavy Industries Ltd.Health Insurance Society General Ota HospitalOtaGunma 373-0056Japan Department of Gastroenterology Shimada Memorial HospitalFujiokaGunma 375-0024Japan

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 liverrelated 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.

关键词： Hepatocellular carcinoma Extremely elderly patients Survival analysis Cause of death

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