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目的探讨老年肝细胞癌患者手术切除术后影响生存的因素。方法回顾性分析1995年1月至2002年12月连续手术切除的老年肝细胞癌患者54例,Kaplan-Meier 法统计术后生存期并进行单因素分析,Cox 回归法进行多因素分析。结果 Child-Pugh 分级、脉管侵犯、卫星灶形成、病理学 Edmondson-Steiner 分级、肝内复发和远处转移影响老年肝细胞癌患者术后总体或无瘤生存(P<0.05)。其中,Child-Pugh 分级和脉管侵犯为术后总体生存的独立影响因素(相对危险度分别为3.37和2.73,P<0.05),而脉管侵犯独立影响无瘤生存(相对危险度为3.19,P<0.05)。结论生物学行为和肝功能状况是影响老年人肝细胞癌预后的主要因素。
Objective To investigate the factors affecting the survival of elderly patients with hepatocellular carcinoma after surgical resection. Methods A total of 54 elderly patients with hepatocellular carcinoma (HCC) underwent surgical resection from January 1995 to December 2002 were retrospectively analyzed. Kaplan-Meier method was used to estimate the postoperative survival time and univariate analysis, and Cox regression was used for multivariate analysis. Results Child-Pugh grading, vascular invasion, satellite lesion formation, pathological Edmondson-Steiner classification, intrahepatic recurrence and distant metastasis affected the overall postoperative survival of patients with hepatocellular carcinoma (P <0.05). Among them, Child-Pugh classification and vascular invasion were independent influencing factors of overall survival (relative risk was 3.37 and 2.73, P <0.05), while vascular invasion independently affected disease-free survival (relative risk was 3.19, P <0.05). Conclusions Biological behavior and liver function status are the main factors affecting the prognosis of hepatocellular carcinoma in the elderly.