| 符合米兰标准的老年肝癌肝移植受者的预后评价:一项基于SEER数据库的回顾性研究 |
| |
| 引用本文： | 余 斌,' target='_blank'>,丁佑铭,' target='_blank'>,廖晓锋,汪 斌,' target='_blank'>,陈晓燕,' target='_blank'>.符合米兰标准的老年肝癌肝移植受者的预后评价:一项基于SEER数据库的回顾性研究[J].现代肿瘤医学,2019,0(20):3652-3656. |
| |
| 作者姓名： | 余 斌 ' target='_blank'> 丁佑铭 ' target='_blank'> 廖晓锋 汪 斌 ' target='_blank'> 陈晓燕 ' target='_blank'> |
| |
| 作者单位： | 1.武汉大学人民医院肝胆腔镜外科，湖北 武汉 430060;2.消化系统疾病湖北省重点实验室，湖北 武汉 430060;3.襄阳市中心医院普外科，湖北 襄阳 441021 |
| |
| 摘 要： | 目的:探讨符合米兰标准的老年（>65岁）肝癌肝移植受者的远期预后。方法:基于美国SEER数据库2004年至2015年间801例符合米兰标准的肝癌肝移植受者的临床数据，利用Kaplan-Meier法比较老年组（>65岁,94例）与青年组（18~65岁，707例）肝移植术后的总体生存率（overall survival，OS）和肝癌特异生存率（liver cancer specific survival，LCSS）。Cox比例风险模型用于分析影响肝癌肝移植受者预后的危险因素。结果:符合米兰标准的老年（66~75岁组、>75岁组）肝癌患者肝移植治疗占比（14.4%、0.2%）显著低于青年肝癌患者（30.3%）（P＜0.05）。肝癌肝移植受者的中位年龄逐年增加，其由2004年至2006年间的55.0岁渐增至2013年至2015年间的60.0岁（P＜0.05）。Kaplan-Meier分析提示青年组OS优于老年组（1、3、5、10年OS，93.5%、83.3%、77.9%、64.0% vs 91.2%、80.8%、66.4%、46.6%，P＜0.05），但二者LCSS无异（1、3、5、10年LCSS，97.5%、91.9%、88.8%、82.7% vs 97.7 %、89.4%、78.1%、73.9%,P＞0.05）。多因素Cox回归分析提示受者年龄、肿瘤分化程度是影响肝癌肝移植受者OS的独立危险因素（均P＜0.05），而肿瘤分化程度、微血管浸润则是影响肝癌肝移植受者LCSS的独立危险因素（均P＜0.05）。结论:受者年龄并不是肝癌肝移植远期预后的良好预测指标；经严格筛选的老年（>65岁）肝癌肝移植受者有机会获得与青年肝癌肝移植受者相近的预后。
|
| 关 键 词： | 肝细胞癌 肝移植 受者年龄 预后 |
Clinical outcomes of liver transplantation for the elderly recipient with hepatocellular carcinoma meeting Milan criteria:a retrospective study based on SEER database |
| |
| Yu Bin,' target='_blank'>,Ding Youming,' target='_blank'>,Liao Xiaofeng,Wang Bin,' target='_blank'>,Chen Xiaoyan,' target='_blank'>.Clinical outcomes of liver transplantation for the elderly recipient with hepatocellular carcinoma meeting Milan criteria:a retrospective study based on SEER database[J].Journal of Modern Oncology,2019,0(20):3652-3656. |
| |
| Authors: | Yu Bin ' target='_blank'> Ding Youming ' target='_blank'> Liao Xiaofeng Wang Bin ' target='_blank'> Chen Xiaoyan ' target='_blank'> |
| |
| Affiliation: | 1.Department of Hepatobiliary and Laparoscopic Surgery,Renmin Hospital of Wuhan University,Hubei Wuhan 430060，China;2.Hubei Key Laboratory of Digestive System Disease,Hubei Wuhan 430060,China;3.Department of General Surgery,Xiangyang Central Hospital,Hubei Xiangyang 441021，China. |
| |
| Abstract: | Objective:To evaluate the impact of recipient age exceeding 65 years on the long-term survival outcomes after LT meeting Milan criteria.Methods:Using the Surveillance,Epidemiology,and End Results database,a total of 801 HCC patients meeting Milan criteria underwent LT were enrolled from 2004 to 2015.Overall survival (OS) and liver cancer-specific survival (LCSS) comparisons were conducted between the elderly group (>65 years,n=94) and young group (18~65 years,n=707).Cox's proportional hazard model was used to evaluate the prognosis-relative factors.Results:The results demonstrated that the elderly HCC patientswere less likely to undergo LT (14.4%、0.2%) as their initial treatments compared to the younger HCC patients meeting criteria (30.3%)(P＜0.05).A trend toward the gradual increase in median patient age (from 55.0 to 60.0 years) in the study period was observed during 2004-2015 (P＜0.05).Kaplan-Meier analyses revealed that younger group had better OS than the elderly group (1-,3-,5-,10-year OS,93.5%,83.3%,77.9%,64.0% vs 91.2%,80.8%,66.4%,46.6%,P＜0.05),butno significant difference was observed between the two groups in terms of LCSS(1-,3-,5-,10-year LCSS,97.5%,91.9%,88.8%,82.7% vs 97.7 %,89.4%,78.1%,73.9%,P＞0.05).Multivariate Cox proportional hazards regression model showed that recipient age,tumor differentiation were the independent predictors of OS,and tumor differentiation and microvascular invasion were the independent predictors of LCSS (all P＜
0.05).Conclusion:Chronologic age is not a good predictor of the outcome of liver transplantation.Carefully selected elderly HCC recipients can achieve similar long-term survival outcomes with the younger HCC recipients if overall clinical conditions and comorbidities allow. |
| |
| Keywords: | hepatocellular carcinoma liver transplantation recipient age prognosis |
|
| 点击此处可从《现代肿瘤医学》浏览原始摘要信息 |
|
点击此处可从《现代肿瘤医学》下载全文 |
|
