Elizabeth M Garcia, Sanjna N Nerurkar, Eunice X Tan, Shaun Y S Tan, Ern-Wei Peck, Sabrina X Z Quek, Readon Teh, Margaret Teng, Andrew Tran, Ee Jin Yeo, Michael Le, Connie Wong, Ramsey Cheung, Daniel Q Huang
{"title":"老年肝细胞癌患者手术切除后的特点和结局：系统回顾和荟萃分析。","authors":"Elizabeth M Garcia, Sanjna N Nerurkar, Eunice X Tan, Shaun Y S Tan, Ern-Wei Peck, Sabrina X Z Quek, Readon Teh, Margaret Teng, Andrew Tran, Ee Jin Yeo, Michael Le, Connie Wong, Ramsey Cheung, Daniel Q Huang","doi":"10.1159/000530101","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.</p><p><strong>Results: </strong>We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).</p><p><strong>Conclusion: </strong>These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.</p><p><strong>Background: </strong>Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.</p><p><strong>Results: </strong>We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).</p><p><strong>Conclusion: </strong>These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"206-214"},"PeriodicalIF":2.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965816/pdf/","citationCount":"0","resultStr":"{\"title\":\"Characteristics and Outcomes of Elderly Hepatocellular Carcinoma Patients following Surgical Resection: Systematic Review and Meta-Analysis.\",\"authors\":\"Elizabeth M Garcia, Sanjna N Nerurkar, Eunice X Tan, Shaun Y S Tan, Ern-Wei Peck, Sabrina X Z Quek, Readon Teh, Margaret Teng, Andrew Tran, Ee Jin Yeo, Michael Le, Connie Wong, Ramsey Cheung, Daniel Q Huang\",\"doi\":\"10.1159/000530101\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.</p><p><strong>Results: </strong>We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).</p><p><strong>Conclusion: </strong>These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.</p><p><strong>Background: </strong>Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.</p><p><strong>Results: </strong>We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).</p><p><strong>Conclusion: </strong>These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.</p>\",\"PeriodicalId\":11294,\"journal\":{\"name\":\"Digestive Diseases\",\"volume\":\" \",\"pages\":\"206-214\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965816/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestive Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000530101\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/3/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000530101","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：由于全球人口老龄化，肝细胞癌（HCC）在老年患者中越来越常见，但肝切除术后的疗效尚不清楚。采用荟萃分析方法，我们旨在评估接受切除术的老年HCC患者的总生存期（OS）、无复发生存期（RFS）和并发症发生率。方法：我们检索了PubMed， Embase和Cochrane数据库，从建立到2020年11月10日，研究报告了老年（年龄≥65岁）HCC患者接受根治性手术切除的结果。使用随机效应模型生成汇总估计。结果：我们筛选了8598篇文章，包括42项研究（7778名老年患者）。平均年龄为74.45岁（95% CI: 72.89-76.02）， 75.54%为男性（95% CI: 72.53-78.32）， 66.73%为肝硬化（95% CI: 43.93-83.96）。平均肿瘤大小为5.50 cm (95% CI: 4.71 ~ 6.29)， 16.01%有多发肿瘤（95% CI: 10.74 ~ 23.19）。非老年和老年患者的1年（86.02% vs. 86.66%, p = 0.84）和5年OS （51.60% vs. 53.78%）相似。同样，非老年和老年患者的1年（67.32% vs. 73.26%, p = 0.11）和5年RFS （31.57% vs. 30.25%, p = 0.67）无差异。老年患者的轻微并发症发生率高于非老年患者（21.95% vs. 13.71%, p = 0.03），但严重并发症发生率无差异（p = 0.43）。结论：这些数据表明，老年和非老年HCC患者肝切除术后的OS、复发和主要并发症具有可比性，可能为该人群HCC的临床管理提供信息。背景：由于全球人口老龄化，肝细胞癌（HCC）在老年患者中越来越常见，但肝切除术后的疗效尚不清楚。采用荟萃分析方法，我们旨在评估接受切除术的老年HCC患者的总生存期（OS）、无复发生存期（RFS）和并发症发生率。方法：我们检索了PubMed， Embase和Cochrane数据库，从建立到2020年11月10日，研究报告了老年（年龄≥65岁）HCC患者接受根治性手术切除的结果。使用随机效应模型生成汇总估计。结果：我们筛选了8598篇文章，包括42项研究（7778名老年患者）。平均年龄为74.45岁（95% CI: 72.89-76.02）， 75.54%为男性（95% CI: 72.53-78.32）， 66.73%为肝硬化（95% CI: 43.93-83.96）。平均肿瘤大小为5.50 cm (95% CI: 4.71 ~ 6.29)， 16.01%有多发肿瘤（95% CI: 10.74 ~ 23.19）。非老年和老年患者的1年（86.02% vs. 86.66%, p = 0.84）和5年OS （51.60% vs. 53.78%）相似。同样，非老年和老年患者的1年（67.32% vs. 73.26%, p = 0.11）和5年RFS （31.57% vs. 30.25%, p = 0.67）无差异。老年患者的轻微并发症发生率高于非老年患者（21.95% vs. 13.71%, p = 0.03），但严重并发症发生率无差异（p = 0.43）。结论：这些数据表明，老年和非老年HCC患者肝切除术后的OS、复发和主要并发症具有可比性，可能为该人群HCC的临床管理提供信息。
Characteristics and Outcomes of Elderly Hepatocellular Carcinoma Patients following Surgical Resection: Systematic Review and Meta-Analysis.
Background: Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.
Methods: We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.
Results: We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).
Conclusion: These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.
Background: Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.
Methods: We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.
Results: We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).
Conclusion: These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.
期刊介绍：
Each issue of this journal is dedicated to a special topic of current interest, covering both clinical and basic science topics in gastrointestinal function and disorders. The contents of each issue are comprehensive and reflect the state of the art, featuring editorials, reviews, mini reviews and original papers. These individual contributions encompass a variety of disciplines including all fields of gastroenterology. ''Digestive Diseases'' bridges the communication gap between advances made in the academic setting and their application in patient care. The journal is a valuable service for clinicians, specialists and physicians-in-training.
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