与肝细胞癌肝移植相比,接受肝切除的老年患者的结果
Sameer A Khan1, Fasih A Ahmed1, Muhammad S Hafeez2
1Department of Surgery, University of Pennsylvania Hospitals System, Philadelphia, Pennsylvania, USA.
Journal of surgical oncology
|August 28, 2023
概括
对于患有肝癌 (HCC) 的老年患者,肝移植 (LT) 提供了比肝切除 (HR) 更好的长期存活率. 年龄不应该是决定老年人获得LT资格的唯一因素.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 移植手术 移植手术 移植手术
- 手术瘤学手术瘤学
背景情况:
- 肝细胞癌 (HCC) 是一种常见的肝癌.
- 肝切除 (HR) 和肝移植 (LT) 是HCC的治疗选择.
- 在老年患者中,越来越多地进行LT.
研究的目的:
- 为了比较老年患者 (≥70岁) 与HCC的HR与LT的长期结果.
- 评估年龄对HCC治疗选择的影响.
主要方法:
- 来自国家癌症数据库 (2004-2020年) 的数据,用于患有HCC的70岁以上的患者.
- 使用卡普兰-梅尔和考克斯回归分析的整体存活率 (OS).
- 倾向性得分匹配用于平衡患者特征.
主要成果:
- 包括5090名患者:4674人 (91.8%) HR,416人 (8.2%) LT.
- 长期治疗组显著改善了生存率 (p<0.001),平均存活时间更长 (HR为97.9个月,HR为65.6个月).
- 多变量分析证实LT独立与改善的生存率相关 (aHR:0.61,95%CI:0.50-0.76).
结论:
- 肝移植 (LT) 在经过精心挑选的患有HCC的老年患者中改善了生存率.
- 仅仅是年龄不应该使老年患者无法考虑LT.
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