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. 2023 Sep 4;13(1):14584.
doi: 10.1038/s41598-023-41771-5.

A nationwide study on the current treatment status and natural prognosis of hepatocellular carcinoma in elderly

Jeong-Ju Yoo #  1 , Jayoun Lee #  2 , Gi Hong Choi  3 , Min Woo Lee  4 , Dong Ah Park  5
Affiliations

A nationwide study on the current treatment status and natural prognosis of hepatocellular carcinoma in elderly

Jeong-Ju Yoo et al. Sci Rep. .

Abstract

The aim of this study was to identify the treatment status and natural prognosis of hepatocellular carcinoma (HCC) patients aged 65 years or older in Korea. We analyzed 3,492 patients' data from the liver cancer stage of the Central Cancer Registry of National Cancer Center. The most common etiology of HCC was hepatitis B (32.7%), followed by hepatitis C. 2624 patients (69.2%) received first-line active treatment for HCC. The most frequently selected treatment was transarterial chemoembolization (TACE), followed by surgical resection and radiofrequency ablation (RFA). The proportion of patients receiving supportive care increased with age. Second-line treatment was performed in only 36.7% of cases, with all others choosing supportive care. Among the various treatments, liver transplantation was found to have the greatest effect in reducing the risk of death (HR [hazard ratio] 0.164, 95% CI [confidence interval] 0.061-0.444), followed by resection, RFA, radioembolization, and TACE. A similar pattern was observed when sub-analyzing the age group over 75 years old. The median survival for untreated HCC in Barcelona Clinic Liver Cancer stage 0/A/B/C/D was 3.7 years, 2.3 years, 7.9 months, 3.9 months, and 2.9 months, respectively. This study highlights the current status of elderly patients with HCC in Korea. While the proportion of patients receiving supportive care is high among the elderly, effective treatment can improve their survival rate.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Survival analysis. (A) Barcelona Clinic Liver Cancer (BCLC) stage, (B) modified the Union for International Cancer Control (UICC) stage.
Figure 2
Figure 2
Comparison of overall survival according to treatment method. (A) All elderly patients (≥ 65 years), (B) very elderly patients (≥ 75 years).
Figure 3
Figure 3
Natural prognosis of untreated hepatocellular carcinoma in elderly. (A) All elderly patients (≥ 65 years), (B) very elderly patients (≥ 75 years).
See this image and copyright information in PMC

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