Background and Aim:Age and biological sex are risk factors for hepatocellular carcinoma (HCC) occurrence, but their impact on overall survival (OS) is a matter of debate. This study aims to investigate how sex and age at diagnosis, along with other associated factors (i.e., comorbidities, etiologies, therapy) impact OS in the HCC population.Method:Data from two HCC cohorts—a prospective registry from the University Hospital of Bern, Switzerland, and a retrospective registry from General Hospital Vienna, Austria—were combined and analyzed. Clinical and laboratory data were reviewed, and OS was compared using Kaplan-Meier curves and the log-rank test. Cox regression models with penalized splines were applied to examine how age at diagnosis influenced OS.Results:Of 1547 HCC patients, 1284 (84.1%) were male. Females were older (67 vs. 63 years,p< 0.001) and had lower rates of liver cirrhosis (p< 0.001), cardiac comorbidities (p< 0.001), and diabetes (p< 0.001). No significant difference in median OS between men and women was observed (18 months vs. 16 months,p= 0.304). Mortality risk increased with age, particularly between 60 and 70 years. However, after adjusting for treatment, the age effect became non-significant (p= 0.171).Conclusions:After controlling the model for therapy, neither age nor sex independently influenced OS in HCC patients, underscoring the impact of therapy on survival.
背景与目的：年龄和生物学性别是肝细胞癌（HCC）发生的风险因素，但它们对总生存期（OS）的影响尚存争议。本研究旨在探讨诊断时的性别和年龄，以及其他相关因素（如合并症、病因、治疗）如何影响HCC人群的OS。方法：本研究合并并分析了来自两个HCC队列的数据——瑞士伯尔尼大学医院的前瞻性登记数据和奥地利维也纳总医院的回顾性登记数据。对临床和实验室数据进行了审查，并使用Kaplan-Meier曲线和对数秩检验比较了OS。应用带惩罚样条的Cox回归模型来检验诊断年龄如何影响OS。结果：在1547例HCC患者中，1284例（84.1%）为男性。女性患者年龄更大（67岁 vs 63岁，p < 0.001），且肝硬化（p < 0.001）、心脏合并症（p < 0.001）和糖尿病（p < 0.001）的发生率更低。男性和女性的中位OS无显著差异（18个月 vs 16个月，p = 0.304）。死亡风险随年龄增长而增加，尤其在60至70岁之间。然而，在调整治疗因素后，年龄效应变得不显著（p = 0.171）。结论：在控制治疗因素后，年龄和性别均未独立影响HCC患者的OS，这突显了治疗对生存的影响。
The Influence of Sex and Age on Survival in Patients with Hepatocellular Carcinoma
肿瘤(癌症)患者之家