Analysis of the efficacy and safety of percutaneous microwave ablation in the treatment of hepatocellular carcinoma in patients over 60 years old with comorbidities
10.3760/cma.j.cn131148-20231107-00203
- VernacularTitle:经皮微波消融治疗60岁以上有合并症肝细胞癌患者的效果及安全性分析
- Author:
Liting HE
1
;
Ting LUO
;
Qiaowei DU
;
Zhen WANG
;
Qian CAI
;
Jie YU
;
Ping LIANG
Author Information
1. 安徽医科大学解放军307临床学院 安徽医科大学第五临床医学院，合肥 230032
- Keywords:
Microwave ablation;
Hepatocellular carcinoma;
Elderly;
Prognosis
- From:
Chinese Journal of Ultrasonography
2024;33(3):201-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the survival prognosis of hepatocellular carcinoma patients over 60 years old with comorbidities treated with microwave ablation.Methods:A retrospective analysis of 267 patients with hepatocellular carcinoma aged 60 years or older admitted to the PLA General Hospital from April 2012 to September 2022 were analyzed, including 179 patients with preoperative comorbidities and 88 patients without comorbidities. The overall survival (OS) and progression-free survival (PFS) of the two groups were compared by the Log-rank test, and the Cox proportional hazards regression model was used to evaluate ablation-related risk factors.Results:A total of 267 patients were included (comorbidity group, n=179; no comorbidity group, n=88). There were no statistical differences in OS and PFS between the two groups (all P>0.05). Multivariate Cox regression analysis showed that comorbidities were not risk factors that affected the survival prognosis (OS and PFS) of patients with hepatocellular carcinoma after microwave ablation ( P>0.05). Total bilirubin (hazard ratio 0.356, 95% CI=0.174-0.731, P=0.005) was a risk factor affecting OS; tumor number (hazard ratio 0.538, 95% CI=0.365-0.793, P=0.002) and international coagulation normalized ratio (hazard ratio 1.022, 95% CI=1.001-1.043, P=0.040) were risk factors affecting PFS. Subgroup analysis showed that patients with a maximum diameter of >3 cm and female patients, the OS of the comorbidity group was significantly lower than that of the non-comorbidity group( P<0.05). Conclusions:Microwave ablation therapy remains an effective treatment modality in hepatocellular carcinoma patients over 60 years of age with comorbidities, and its survival prognosis is not inferior to patients with hepatocellular carcinoma without comorbidities.
