Survival Analysis of Hepatocellular Carcinoma： A Comparison Between Young Patients and Aged Patients

Background： To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma （HCC）. Methods： We analyzed the outcome of 451 HCC patients underwent liver resection, transcatheter arterial chemoembolization and radiofrequency ablation, respectively. Then risk factors for aged and younger patients＇ survival were evaluated by multivariate analysis, respectively. Results： The patients who were older lhan 55 years old were defined as the older group. The overall survival for aged patients was significantly worse than those younger patients. The younger patients had similar liver fhnctional reserve but more aggressive tumor Paclors than aged patients. Cox regression analysis showed that tile elevated levels ofaspartate aminotransferase （AST） （Waldx2= 3.963, P = 0.047, hazard ratio [HR] -1.453, 95% confidence interval [CI]： 1.006-2.098）, lower albumin （Wald X2 = 12.213, P 〈 0.001, HR 1.982, q5% CI： 1.351 2.910）, tumor size （Wald X2 = 8.179, P- 0,004, HR - 1.841,95% CI： 1.212-2.797）, and higher alpha-fetoprotein level （Wald X2=4.044, P = 0.044, HR = 1,465, 95% （CI： 1.010 2.126） were independent prognostic factors for aged patients, while only elevated levelsofAST（WaldZ= 14.491,P〈0.001,HR 2.285, 95%CI： 1.493-3.496）andtumorsize（WaldX2= 21.662, P〈0.001,HR= 2.928, 95% CI： 1.863-4.604） were independent prognostic factors for younger patients. Conclusions： Age is a risk factor to determine the prognosis of patients with HCC. Aged patients who have good liver lhnctional reserve are still encouraged to receive curative therapy.