title: 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.
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Kim
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Kim
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Chung
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012044:Regression Analysis; D056910:Republic of Korea; D012189:Retrospective Studies; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D000509:alpha-Fetoproteins
keywords: Elderly; Hepatocellular Carcinoma; Prognosis; Survival