title: Hepatocellular carcinoma in older adults: clinical features, treatments, and survival.
abstract: OBJECTIVE
  To evaluate the clinical features, treatments, stages, and survival in older adults with hepatocellular carcinoma (HCC).
  
  
  METHODS
  A consecutive case study with retrospective medical record review.
  
  
  METHODS
  University hospital (tertiary referral center) in Korea.
  
  
  METHODS
  Two hundred sixty-two participants with HCC diagnosed between May 1, 2003, and December 31, 2006.
  
  
  METHODS
  Clinical characteristics, treatments, four staging systems for HCC, and survival in older (≥65, n=113) and younger (<65, n=149) people with HCC.
  
  
  RESULTS
  The older HCC group were less likely to have hepatitis B virus infection and diffuse tumors and had more comorbidities, poorer performance status, smaller tumor area, and multinodular disease. There were no significant differences between the two groups with regard to Child-Pugh-Turcotte score, Model for End Stage Liver Disease (MELD) score, Child class, alpha-fetoprotein levels, and tumor stage at diagnosis. Approximately 88% of subjects were treated regardless of age, but resection was performed less frequently in the older participants. Older participants with HCC had overall survival and liver-related mortality similar to those of the younger participants, although they had poorer performance, greater comorbidity, and less likelihood of receiving surgery than the younger patients.
  
  
  CONCLUSIONS
  This study supports the effectiveness and safety of nonsurgical treatment for older adults with HCC. Further study is needed to elucidate the reasons for similar prognoses in the older adults in spite of the greater burdens of comorbidities and poorer performance status.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea.
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Hyun Cheul
authors.initials: HC
authors.lastname: Choi
authors.forename: Sook-Hyang
authors.initials: SH
authors.lastname: Jeong
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Lee
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Chung
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Jin-Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Choi
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Sung Gwon
authors.initials: SG
authors.lastname: Kang
mesh_terms: D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends