BACKGROUND/AIMS: This study aimed to elucidate the clinical characteristics of patients with chronic liver disease aged 80 years or more, especially the factors affecting prognosis and carcinogenesis. METHODS: A total of 135 patients aged 80 years or above were divided into chronic liver disease without cirrhosis (non-LC) and cirrhosis (LC) groups according to the severity of fibrosis, and the clinical characteristics and prognoses were evaluated. RESULTS: Seventy-three (54.1%) of 135 patients were in the LC group and 79 patients (58.5%) had hepatitis C virus. Various concomitant diseases were seen in 122 patients (90.4%). Liver-related deaths occurred in only 19 (36.5%) of 52 patients who died during observation, although 28 patients (53.8%) had liver cancer at the time of death. Cumulative survival rates in the non-LC and the LC groups were 85.7% and 58.8% at the 5th year, and 69.4% and 19.4% at the 9th year, respectively. Cumulative liver cancer appearance rates in the non-LC and the LC groups were 1.6% and 6.1% at the 1st year, 12.4% and 19.9% at the 5th year, and 12.4% and 32.0% at the 7th year, respectively. A multivariate Cox regression analysis revealed that the presence of liver cancer (p=0.0001), platelet count (p=0.0242), and fibrotic stage (p=0.0118) were independently associated with survival period, and alfa-fetoprotein (p=0.0194) and bilirubin (p=0.0282) were independently associated with carcinogenesis. CONCLUSIONS: Cirrhosis is the major risk factor affecting the prognosis. On the other hand, we must pay more attention to concomitant diseases specific to advanced age.
BACKGROUND/AIMS: This study aimed to elucidate the clinical characteristics of patients with chronic liver disease aged 80 years or more, especially the factors affecting prognosis and carcinogenesis. METHODS: A total of 135 patients aged 80 years or above were divided into chronic liver disease without cirrhosis (non-LC) and cirrhosis (LC) groups according to the severity of fibrosis, and the clinical characteristics and prognoses were evaluated. RESULTS: Seventy-three (54.1%) of 135 patients were in the LC group and 79 patients (58.5%) had hepatitis C virus. Various concomitant diseases were seen in 122 patients (90.4%). Liver-related deaths occurred in only 19 (36.5%) of 52 patients who died during observation, although 28 patients (53.8%) had liver cancer at the time of death. Cumulative survival rates in the non-LC and the LC groups were 85.7% and 58.8% at the 5th year, and 69.4% and 19.4% at the 9th year, respectively. Cumulative liver cancer appearance rates in the non-LC and the LC groups were 1.6% and 6.1% at the 1st year, 12.4% and 19.9% at the 5th year, and 12.4% and 32.0% at the 7th year, respectively. A multivariate Cox regression analysis revealed that the presence of liver cancer (p=0.0001), platelet count (p=0.0242), and fibrotic stage (p=0.0118) were independently associated with survival period, and alfa-fetoprotein (p=0.0194) and bilirubin (p=0.0282) were independently associated with carcinogenesis. CONCLUSIONS:Cirrhosis is the major risk factor affecting the prognosis. On the other hand, we must pay more attention to concomitant diseases specific to advanced age.
Authors: Toshiharu Sakurai; Masatoshi Kudo; Atsushi Umemura; Guobin He; Ahmed M Elsharkawy; Ekihiro Seki; Michael Karin Journal: Cancer Res Date: 2012-12-27 Impact factor: 12.701