UNASSIGNED: We conducted a search across the Ovid-Medline, Ovid-EMBASE, and Cochrane Library to identify comparative studies involving primary HCC in elderly patients (≥65 years). Efficacy-related outcomes encompassed overall survival (OS) and disease-free survival (DFS), while safety-related outcomes included post-operative mortality, complications, and length of stay (LOS).
UNASSIGNED: We identified nine eligible cohort studies comprising 1,599 patients. LLR demonstrated comparable 3- and 5-year DFS [hazard ratio (HR) =1.00, 95% confidence interval (CI): 0.98-1.02; HR =1.02, 95% CI: 0.99-1.05] and 3- and 5-year OS (HR =1.01, 95% CI: 0.99-1.02; HR =1.02, 95% CI: 0.99-1.06, respectively) compared to OLR. In terms of safety, there was no significant difference between LLR and OLR in in-hospital mortality [odds ratio (OR) =0.19; 95% CI: 0.02-1.69], 30-day mortality (OR =0.33; 95% CI: 0.03-3.20), and 90-day mortality (OR =0.70; 95% CI: 0.32-1.53). Additionally, LLR presented fewer overall complications (OR =0.53; 95% CI: 0.41-0.67), a lower rate of major complications (OR =0.51; 95% CI: 0.35-0.74), a reduced incidence of liver failure (OR =0.56; 95% CI: 0.33-0.94), and a shorter LOS compared to OLR (mean difference: -14.47 days).
UNASSIGNED: LLR exhibited comparable clinical efficacy and superior safety and fewer complications when compared to OLR in elderly patients with HCC requiring surgery.
■我们在Ovid-Medline进行了搜索,Ovid-EMBASE,和Cochrane图书馆,以确定涉及老年患者(≥65岁)原发性肝癌的比较研究。疗效相关结果包括总生存期(OS)和无病生存期(DFS),而与安全相关的结果包括术后死亡率,并发症,和停留时间(LOS)。
■我们确定了9项符合条件的队列研究,包括1,599名患者。与OLR相比,LLR显示出具有可比性的3年和5年DFS[风险比(HR)=1.00,95%置信区间(CI):0.98-1.02;HR=1.02,95%CI:0.99-1.05]和3年和5年OS(HR=1.01,95%CI:0.99-1.02;HR=1.02,95%CI:0.99-1.06)。在安全方面,住院死亡率LLR和OLR之间没有显着差异[比值比(OR)=0.19;95%CI:0.02-1.69],30天死亡率(OR=0.33;95%CI:0.03-3.20),和90天死亡率(OR=0.70;95%CI:0.32-1.53)。此外,LLR总体并发症较少(OR=0.53;95%CI:0.41-0.67),主要并发症的发生率较低(OR=0.51;95%CI:0.35-0.74),肝功能衰竭的发生率降低(OR=0.56;95%CI:0.33-0.94),与OLR相比,LOS较短(平均差:-14.47天)。
■LLR在需要手术的老年HCC患者中与OLR相比,表现出相当的临床疗效和优越的安全性以及更少的并发症。