title: Characteristics of elderly hepatitis C virus-associated hepatocellular carcinoma patients.
abstract: OBJECTIVE
  The average age of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients has been rising in Japan. We evaluate characteristics of HCV-positive patients who develop HCC in older age to determine an optimal surveillance strategy.
  
  
  METHODS
  A total of 323 patients with three or more years of follow-up before HCC diagnosis and 323 propensity-matched controls without HCC were studied. HCC patients were classified into four groups according to age at the time of HCC diagnosis: group A (≤ 60 years, n = 36), group B (61-70 years, n = 115), group C (71-80 years, n = 143), and group D (> 80 years, n = 29). Clinical and laboratory data were compared.
  
  
  RESULTS
  Platelet counts were significantly higher in the older groups at HCC diagnosis (P < 0.0001). The rate of platelet counts decline was lower in older groups (P = 0.0107). The average integration value of serum alanine aminotransferase (ALT) in groups A, B, C, and D were 80.9 IU/L, 62.3 IU/L, 59.0 IU/L, and 44.9 IU/L, respectively (P < 0.0001). In older patients (≥ 65 years old), cirrhosis and average integration value of ALT were significantly associated with hepatocarcinogenesis, but platelet count was not.
  
  
  CONCLUSIONS
  Elderly HCV-positive patients (≥ 65 years old) with low ALT values developed HCC regardless of their platelet counts. These findings should be taken into account when designing the most suitable HCC surveillance protocol for this population.
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan. hosp3@omh.ogaki.gifu.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hisanaga
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004796:Clinical Enzyme Tests; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D015996:Survival Rate; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins; D000410:Alanine Transaminase