Hepatocellular carcinoma in extremely elderly patients: an analysis of clinical characteristics, prognosis and patient survival.
OBJECTIVE
To identify the clinical and prognostic features of patients with hepatocellular carcinoma (HCC) aged 80 years or more.


METHODS
A total of 1310 patients with HCC were included in this study. Ninety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged > or = 50 years but less than 60 years were regarded as the non-elderly group.


RESULTS
The sex ratio (male to female) was significantly lower in the extremely elderly group (0.90:1) than in the non-elderly group (3.9:1, P < 0.001). The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group (P < 0.001). There were no significant differences in the following parameters: diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment (P < 0.001) and they were more likely to receive conservative treatment (P < 0.01). There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage I/II, stage I/II and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liver-related diseases even in the extremely elderly patients.


CONCLUSIONS
In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in the extremely elderly patients.
Tsukioka
Gengo
G
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Kakizaki
Satoru
S
Sohara
Naondo
N
Sato
Ken
K
Takagi
Hitoshi
H
Arai
Hirotaka
H
Abe
Takehiko
T
Toyoda
Mitsuo
M
Katakai
Kenji
K
Kojima
Akira
A
Yamazaki
Yuichi
Y
Otsuka
Toshiyuki
T
Matsuzaki
Yutaka
Y
Makita
Fujio
F
Kanda
Daisuke
D
Horiuchi
Katsuhiko
K
Hamada
Tetsuya
T
Kaneko
Mieko
M
Suzuki
Hideyuki
H
Mori
Masatomo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy; D002423:Cause of Death; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate