Hepatocellular carcinoma in the elderly: clinical characteristics, treatment, survival analysis in Korean patients older than 70 years

Abstract

The prevalence of hepatocellular carcinoma (HCC) has increased in recent years. However, HCC remains poorly characterized in elderly patients, and comprehensive data are limited. This study aimed to investigate the clinical characteristics, prognostic features and survival outcome of elderly HCC patients. We retrospectively analyzed 992 HCC patients treated at Dongsan Hospital from January 2003 to December 2007. The patients were divided into two age groups: < 70 yr (n = 813) and ≥ 70 yr (n = 179). Elderly HCC patients, compared to younger patients, had significantly higher incidence of females (31.3% vs 18.9%, P = 0.001), hepatitis C-related disease (HCV antibody positivity 26.3% vs 9.2%, P = 0.001) and comorbid condition (53.6% vs 32.1%), but lower rates of hepatitis B-related disease (HBs antigen positivity 31.3% vs 69.4%, P = 0.001). There were no significant differences in underlying liver function, stage and survival outcomes. Factors significantly influencing the prognosis of HCC were Child-Pugh grade, number of HCC, level of alpha-fetoprotein, presence of metastasis. The survival outcome of older patients with HCC was not different from that of younger patients. There were no differences between groups in independent factors influencing the prognosis of HCC. Therefore, determining the optimal management strategy for elderly HCC patients is important to improve survival and long-term outcomes.

Keywords: Elderly; Hepatocellular Carcinoma; Prognosis; Survival.

Fig. 1

Accumulated survival between old (≥70 yr) and young (<70 yr) HCC patients. HCC, hepatocellular carcinoma.

Fig. 2

Comparison of overall survival between old (≥ 70 yr) and young (< 70 yr) HCC patients according to age in terms of treatment (A) Palliative group. (B) Non-palliative group). HCC, hepatocellular carcinoma.

Fig. 3

Comparison of overall survival between old (≥ 70 yr) and young (< 70 yr) HCC patients depending on whether treatment (A, old [≥ 70 yr] group; B, young [<70 yr] group). HCC, hepatocellular carcinoma.