title: The outcomes and safety of single-agent sorafenib in the treatment of elderly patients with advanced hepatocellular carcinoma (HCC).
abstract: BACKGROUND
  With the aging population, hepatocellular carcinoma (HCC) in the elderly represents a significant health burden. We aimed to evaluate and compare the efficacy and tolerability of single-agent sorafenib in treating elderly patients with advanced HCC versus the younger population.
  
  
  METHODS
  We retrospectively analyzed a consecutive cohort of advanced HCC patients with Child-Pugh A or B liver function and an Eastern Cooperative Oncology Group performance status score of 0-2 treated with sorafenib. The patients were categorized into older (age ≥70 years) and younger (age <70 years) groups. Treatment outcomes and related adverse events (AEs) were compared.
  
  
  RESULTS
  In total, 172 patients, 35 in the older (median age, 73 years) and 137 in the younger (median age, 55 years) group, were analyzed. The median progression-free survival time was similar in the older and younger groups (2.99 months versus 3.09 months; p = .275), as was the overall survival time (5.32 months versus 5.16 months; p = .310). Grade 3 or 4 AEs were observed in 68.6% of older and 62.7% of younger patients (p = .560), with neutropenia (11.4% versus 0.7%; p = .007), malaise (11.4% versus 2.2%; p = .033), and mucositis (5.7% versus 0.0%; p = .041) being more frequently reported in the elderly cohort.
  
  
  CONCLUSIONS
  The survival benefits and overall treatment-related AEs of sorafenib are comparable in elderly and younger advanced HCC patients. Nevertheless, more vigilant monitoring in the elderly is warranted because they are more susceptible to develop neutropenia, malaise, and mucositis.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Hilda
authors.initials: H
authors.lastname: Wong
authors.forename: Yuen Fong
authors.initials: YF
authors.lastname: Tang
authors.forename: Tzy-Jyun
authors.initials: TJ
authors.lastname: Yao
authors.forename: Joanne
authors.initials: J
authors.lastname: Chiu
authors.forename: Roland
authors.initials: R
authors.lastname: Leung
authors.forename: Pierre
authors.initials: P
authors.lastname: Chan
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Albert C
authors.initials: AC
authors.lastname: Chan
authors.forename: Roberta W
authors.initials: RW
authors.lastname: Pang
authors.forename: Ronnie
authors.initials: R
authors.lastname: Poon
authors.forename: Sheung-Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Thomas
authors.initials: T
authors.lastname: Yau
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib