Prognostic analysis of systemic antitumor therapy in young patients with advanced liver cancer: A cohort study

Zhang,Jue; Chen,Chao; Xia,Zhaojun; Xiong,Xi; Liu,Ping; Xu,Yanping; Liu,Xiufeng; Li,Zixiong

doi:10.3892/ol.2024.14544

Prognostic analysis of systemic antitumor therapy in young patients with advanced liver cancer: A cohort study

Authors:
- Jue Zhang
- Chao Chen
- Zhaojun Xia
- Xi Xiong
- Ping Liu
- Yanping Xu
- Xiufeng Liu
- Zixiong Li
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Affiliations: Department of Oncology, Nanjing Jinling Hospital of Nanjing University, Nanjing, Jiangsu 210012, P.R. China, Department of Hepatology, Nanjing Jinling Hospital of Nanjing University, Nanjing, Jiangsu 210002, P.R. China
Published online on: June 28, 2024 https://doi.org/10.3892/ol.2024.14544
Article Number: 410
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Advanced liver cancer is the most common malignant tumor in the elderly, but it also occurs in young people in areas where hepatitis B virus is prevalent. The aim of the present study was to assess the efficacy of systemic antitumor therapy in young patients with advanced liver cancer and investigate the influencing factors. The baseline demographic and clinical data of 38 young patients (≤35 years old) with liver cancer were collected as group A and that of 79 elderly patients (≥55 years old) with liver cancer were collected as group B. There were no significant between‑group differences regarding the proportion of patients with increased serum aspartate aminotransferase, low serum albumin, increased α‑fetoprotein (AFP) and high Child‑Pugh score. The median (m)PFS time in groups A and B was 3.9 and 8.3 months, respectively [hazard ratio (HR), 1.702; P=0.009]. The mOS in group A (17.6 months) was 12.4 months shorter than that in group B (HR, 1.799; P=0.010). In the subgroup analysis, male sex [HR, 1.73; 95% confidence interval (CI), 1.07‑2.79], pathological diagnosis (HR, 1.79; 95% CI, 1.10‑2.91), previous surgical treatment (HR, 2.16; 95% CI, 1.18‑3.95), no tumor thrombus (HR, 2.45; 95% CI, 1.22‑4.93), increased alanine aminotransferase (HR, 2.23; 95% CI, 1.07‑4.65), increased aspartate aminotransferase (HR, 3.22; 95% CI, 1.62‑6.39), normal total bilirubin (HR, 1.77; 95% CI, 1.09‑2.87) and increased AFP (HR, 2.02; 95% CI, 1.19‑3.41) were associated with shorter survival time in group A compared with those in group B (P<0.05). Group A also had a higher incidence of hyper‑progressive disease (HPD) (31.6 vs. 3.8%; P<0.001). HPD was a risk factor for advanced liver cancer (HR, 4.530; 95% CI, 2.251‑9.115; P<0.001]. In conclusion, the efficacy of systemic antitumor therapy in young patients was poorer compared with that in elderly patients. Young patients with liver cancer had a high HBV infection rate and were prone to HPD.

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