OBJECTIVES: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is expected to increase. We compared the presenting features and outcome of HCC in elderly (>or=70 years) and younger patients (<70 years). DESIGN: Multicentre retrospective cohort study and nested case-control study. Patients 614 elderly and 1104 younger patients from the ITA.LI.CA database, including 1834 HCC cases consecutively diagnosed from January 1987 to December 2004. Both groups were stratified according to treatment: hepatic resection, percutaneous procedures, transarterial chemoembolisation (TACE). Survival was assessed in the whole population and in each treatment subgroup. Age, sex, aetiology, cirrhosis, comorbidities and cancer stage (CLIP score) were tested as predictors of survival. In each subgroup, differences in patient survival were also assessed after adjustment and matching by propensity score. RESULTS: Ageing was associated with a higher prevalence of comorbidities, better liver function and CLIP score. Regardless of age, two-thirds of patients underwent radical treatments or TACE. Elderly patients underwent more ablative procedures and fewer resections or TACE sessions. The survival of elderly and younger patients was comparable in each treatment subset, and was predicted by CLIP score. This result was confirmed by the propensity analysis. CONCLUSIONS: The overall applicability of radical or effective HCC treatments was unaffected by old age. However, treatment distribution differed, elderly individuals being more frequently treated with percutaneous procedures and less frequently with resection or TACE. Survival was unaffected by age and primarily predicted by cancer stage, assessed by the CLIP system, both in the overall population and in treatment subgroups.
OBJECTIVES: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is expected to increase. We compared the presenting features and outcome of HCC in elderly (>or=70 years) and younger patients (<70 years). DESIGN: Multicentre retrospective cohort study and nested case-control study. Patients 614 elderly and 1104 younger patients from the ITA.LI.CA database, including 1834 HCC cases consecutively diagnosed from January 1987 to December 2004. Both groups were stratified according to treatment: hepatic resection, percutaneous procedures, transarterial chemoembolisation (TACE). Survival was assessed in the whole population and in each treatment subgroup. Age, sex, aetiology, cirrhosis, comorbidities and cancer stage (CLIP score) were tested as predictors of survival. In each subgroup, differences in patient survival were also assessed after adjustment and matching by propensity score. RESULTS: Ageing was associated with a higher prevalence of comorbidities, better liver function and CLIP score. Regardless of age, two-thirds of patients underwent radical treatments or TACE. Elderly patients underwent more ablative procedures and fewer resections or TACE sessions. The survival of elderly and younger patients was comparable in each treatment subset, and was predicted by CLIP score. This result was confirmed by the propensity analysis. CONCLUSIONS: The overall applicability of radical or effective HCC treatments was unaffected by old age. However, treatment distribution differed, elderly individuals being more frequently treated with percutaneous procedures and less frequently with resection or TACE. Survival was unaffected by age and primarily predicted by cancer stage, assessed by the CLIP system, both in the overall population and in treatment subgroups.
Authors: Andreas Andreou; Safak Gül; Andreas Pascher; Wenzel Schöning; Hussein Al-Abadi; Marcus Bahra; Fritz Klein; Timm Denecke; Benjamin Strücker; Gero Puhl; Johann Pratschke; Daniel Seehofer Journal: HPB (Oxford) Date: 2014-09-28 Impact factor: 3.647
Authors: Sukeshi Patel Arora; Gabor Liposits; Susan Caird; Richard F Dunne; Gordon Taylor Moffat; David Okonji; Maria Grazia Rodriquenz; Divyanshu Dua; Efrat Dotan Journal: J Geriatr Oncol Date: 2019-11-06 Impact factor: 3.599
Authors: Emmanuel A Tsochatzis; Evangelia Fatourou; James O'Beirne; Tim Meyer; Andrew K Burroughs Journal: World J Gastroenterol Date: 2014-03-28 Impact factor: 5.742
Authors: Felix Krenzien; Moritz Schmelzle; Benjamin Struecker; Nathanael Raschzok; Christian Benzing; Maximilian Jara; Marcus Bahra; Robert Öllinger; Igor M Sauer; Andreas Pascher; Johann Pratschke; Andreas Andreou Journal: J Gastrointest Surg Date: 2018-01-23 Impact factor: 3.452
Authors: Ji Eun Lee; Si Hyun Bae; Jong Young Choi; Seung Kew Yoon; Young Kyoung You; Myung Ah Lee Journal: World J Gastroenterol Date: 2014-01-07 Impact factor: 5.742