Long-term outcome of elderly patients (75 years or older) with hepatocellular carcinoma

Maisa Hori; Masatoshi Tanaka; Eiji Ando; Masahiro Sakata; Shigeo Shimose; Miki Ohno; Shigeru Yutani; Kei Kuraoka; Ryoko Kuromatsu; Shuji Sumie; Michio Sata

doi:10.1111/hepr.12279

Long-term outcome of elderly patients (75 years or older) with hepatocellular carcinoma

Hepatol Res. 2014 Sep;44(9):975-82. doi: 10.1111/hepr.12279. Epub 2014 Feb 10.

Authors

Maisa Hori¹, Masatoshi Tanaka, Eiji Ando, Masahiro Sakata, Shigeo Shimose, Miki Ohno, Shigeru Yutani, Kei Kuraoka, Ryoko Kuromatsu, Shuji Sumie, Michio Sata

Affiliation

¹ Division of Gastroenterology, Department of Medicine, Kurume University Medical Center, Fukuoka, Japan.

PMID: 24256493
DOI: 10.1111/hepr.12279

Abstract

Aim: The aim of this study was to evaluate the long-term outcome of elderly patients with hepatocellular carcinoma (HCC) aged 75 years or older.

Methods: The study included 422 patients with HCC, who were divided into two age groups: 75 years or older (n = 140) and younger than 75 (n = 282). Outcomes were compared between the two groups.

Results: The number of elderly patients treated with supportive care alone (33 patients; 24%) was significantly higher than younger patients (30 patients; 11%, P < 0.01). The 1-, 3-, 5- and 7-year overall survival rates of the elderly patients (81%, 55%, 39% and 23%, respectively) were worse than those of younger patients (85%, 64%, 49% and 36%, respectively, P = 0.042). However, the overall survival rate of the elderly group after excluding 63 patients treated with supportive care alone, was similar to that of the younger group (P = 0.615). Multivariate analysis identified age, total bilirubin levels, albumin levels, serum des-γ-carboxy prothrombin levels, tumor size, number of HCC nodules, vascular invasion, extrahepatic metastasis and treatment modality as independent and significant factors of overall survival.

Conclusion: Advanced age is a negative prognostic factor in patients with HCC due to the tendency for frequent use of conservative treatment rather than locoregional or surgical treatment.

Keywords: elderly; hepatocellular carcinoma; prognosis; therapy.