| Objective:With the aging of the world’s population,malignant diseases of the elderly have gradually become a global problem,and systematic research and development for the prevention,diagnosis and treatment of this special liver cancer group that has gradually become a new public health problem.The diagnosis and treatment procedures and programs of patients with hepatocellular carcinoma were retrospectively analyzed in the elderly group(≥60 years old)and non-elderly group(<60 years old)patients with Hepatocellular Carcinoma(HCC)who underwent concurrent hepatectomy in a single center,In order to further improve the treatment effect of this special population of elderly patients with liver cancer,obtain a certain survival time and control tumor progression,at the same time provide evidence for more clinical diagnosis and treatment of elderly patients with liver cancer.Materials and Methods:Laboratory examination,imaging examination,histopathology,prognosis,etc.of patients diagnosed with HCC concurrent surgical resection in our hospital(Hepatobiliary Surgery,the First Affiliated Hospital of Guangxi Medical University)from May 2012 to April 2015 were collected.Case data,etc.,combined with domestic and foreign literature,retrospective analysis of clinical and pathological features of patients with advanced HCC surgery in our hospital.Results:We underwent radical hepatectomy for liver cancer in two age groups.The time to tumor-free survival(DFS)in 277 patients with HCC was(3.33 to 66.90)months,and the median DFS time was 68.7 months,1 year.The3-year and 5-year disease-free survival rates were 74.0%,57.0%,and 49.0%,respectively.In the non-elderly group(<60 years old),the DFS time was(3.3~66.9)months,the median DFS time was 60.0 months,and the 1-,3-,and5-year disease-free survival rates were 73.0%and 58.0%,respectively.And51.0%,in the elderly group(≥60 years old),the DFS time was(3.7~66.7)months,the median DFS time was 49.8 months,and the 1-,3-,and 5-year disease-free survival rates were 76.0%,51.0%and 43.0%.The median DFS time between<60 years and≥60 years was compared,Log Rank?2was 0.476,P=0.49>0.05.Statistics are not significant.277 patients were divided into the elderly group(≥60 years old)and non-elderly group(<60 years old).The results of single factor analysis showed age,alcohol consumption,hypertension,history of hepatitis B,ascites,hepatitis B surface antigen positive,preoperative hemoglobin,surgery The difference in prealbumin was statistically significant,but there was no statistically significant difference in the time of surgery,tumor size,capsule,differentiation,stage,BCLC stage,Child classification,portal vein tumor thrombus,microvascular invasion,and recurrence.Regarding recurrence factors,non-elderly cirrhosis,hepatitis B e antigen,hepatitis B e-antibody AST,ALT are factors influencing postoperative recurrence of HCC patients,considering the active replication of chronic hepatitis B virus,whether P<0.05 in single factor analysis Cirrhosis,hepatitis B e antigen,hepatitis B e antibody,AST and ALT were included in the COX regression model.It was found that cirrhosis,hepatitis B e antigen,hepatitis B e antibody,AST and ALT were not independent factors affecting the tumor-free survival of patients with HCC;Among the demographic characteristics of patients with HCC,BMI,ascites,fatty liver,splenomegaly,Child classification,preoperative bilirubin and AST were the influencing factors of postoperative recurrence in HCC patients.However,single factor was included in COX regression model and found to be BMI and ascites were independent influencing factors of recurrence after HCC in patients aged 60 years or older.For patients with HCC with BMI≥24kg/m~2 as reference,the risk of recurrence of HCC patients with BMI<18.5 kg/m~2 was 5.3times higher than that of HCC patients with BMI≥24kg/m~2.Conclusion:There is no significant difference in postoperative tumor-free survival between the two groups.Considering the prognosis after radical resection,age is not the main risk of feasibility of hepatectomy.Radical surgery is similar in elderly and non-elderly patients.Benefits,and indicators such as hepatitis B and cirrhosis ascites are all risk factors for recurrence,mainly due to hepatitis activity or hepatitis B cirrhosis,because HCC with hepatitis B background should be treated with life-long antiviral therapy;BMI<18.5 kg/m~2is more likely to relapse to consider the disease or the risk of nutrition,so patients with nutritional risks in the elderly are more likely to pay attention to strengthen nutrition in order to reduce the risk of recurrence. |
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