行肝癌根治术的老年肝癌患者临床特点及长期预后研究  

Characteristics and Long- term Outcomes of Elderly Patients With Liver Cancer After Radical Surgery

作　　者：武伟[1] 李国兰[2] 周洪伟[1] 潘万能 

机构地区：[1]杭州师范大学附属医院普外科,浙江省杭州市310015 [2]杭州师范大学附属医院麻醉科,浙江省杭州市310015 [3]杭州市传染病医院肝胆外科

出　　处：《中国全科医学》2016年第14期1663-1666,共4页Chinese General Practice

摘　　要：目的探讨行肝癌根治术的老年肝癌患者的临床特点及长期预后。方法选取2004年1月～2014年12月在杭州师范大学附属医院行肝癌根治术的患者324例，其中277例患者年龄〈70岁为非老年组；47例患者年龄≥70岁为老年组。比较两组患者一般资料以及术后短期疗效（包括术后并发症、术后病死率）、长期预后（包括复发、死亡、5年无瘤生存率、5年总体生存率）。结果非老年组和老年组患者性别、病程、Child．PughA级、甲胎蛋白〉400肛g／L发生率比较，差异均无统计学意义（P〉0．05）；非老年组乙型肝炎表面抗原阳性、乙型肝炎病毒及丙型肝炎病毒感染率、肝硬化发生率高于老年组（P〈0．05）。两组患者术中失血量、术后并发症发生率、术后并发症严重程度、TNM分期比较，差异均无统计学意义（P〉0．05）；老年组患者广泛肝切除术率高于非老年组（P〈0．05）。两组复发率、肿瘤复发部位、复发治疗措施及病死率比较，差异均无统计学意义（P〉O．05）。两组5年无瘤生存率及5年总体生存率比较，差异均无统计学意义（X2=0．937，P=0．333；x2=0．602，P=0．438）。结论老年肝癌患者行肝癌根治术后，其术后并发症发生率、严重程度及长期预后与非老年肝癌患者类似，肝癌根治术可提高老年肝癌患者的预期寿命。Objective To investigate the characteristics and long- term outcomes of elderly patients with liver cancer after radical surgery. Methods From January 2004 to December 2014,we enrolled 324 patients who underwent radical surgery for liver cancer. Among them,277 patients aged 〈 70 were assigned into non- elderly group,and 47 patients aged ≥70 were assigned into elderly group. Comparison was made between the two groups in general data,postoperative short- term efficacy（ including postoperative complications and postoperative mortality）,and long- term prognosis（ including relapse,death,5-year disease- free survival rate,and 5-year overall survival rate）. Results The two groups were not significantly different in gender,course of disease,Child-Pugh A grading and incidence of alpha fetoprotein 〉400 μg / L（ P〉0. 05）; non- elderly group was higher in the incidence rates of patients positive hepatitis B surface antigen,infection of viral hepatitis B and viral hepatitis C,and liver cirrhosis than elderly group（ P〈 0. 05）. The two groups were not significantly different in blood loss volume,incidence of postoperative complications, the severity of postoperative complications, TNM staging（ P〉0. 05）;elderly group was higher than non- elderly group in the rate of extensive liver resection（ P〈 0. 05）. The two groups were not significantly different in recurrence rate,recurrence site,measures for recurrence and mortality（ P〉 0. 05）. The two groups were not significantly different in 5-year disease-free survival rate and 5-year overall survival rate（ χ^2= 0. 937,P = 0. 333;χ^2= 0. 602,P = 0. 438）. Conclusion Elderly liver cancer patients have similar incidence and severity of complications and long-term prognosis with non-elderly liver cancer patients after radical surgery. The radical surgery for liver cancer can improve the life expectancy of elderly patients.

关 键 词：肝肿瘤 老年人 肝切除术 预后 

分 类 号：R735.7[医药卫生—肿瘤]