title: Treatment of hepatocellular carcinoma in elderly patients.
abstract: OBJECTIVE
  The aim of this study was to compare the survival in elderly hepatocellular carcinoma (HCC) patients treated with curative modalities (radiofrequency ablation (RFA), percutaneous ethanol injection (PEIT) and surgery) to those treated with transcatheter arterial chemoembolization (TACE) and supportive care.
  
  
  METHODS
  Medical records of patients with HCC older than 75 years who had visited a single tertiary medical center from January 2000 to December 2011 were reviewed (n = 58). Multivariable-adjusted hazard ratios (HR) for mortality with 95% confidence intervals (CI) were estimated using Cox proportional hazard models.
  
  
  RESULTS
  Twenty-nine patients were treated by TACE, 19 patients by supportive care, and 10 patients by curative treatment (four by PEIT, three by surgery and three by RFA).Variables associated with increased survival were better Child-Pugh class and lower TNM stage. Treatment with curative intent showed significant survival benefit compared to TACE (HR for mortality, 0.10; 95% CI, 0.01-0.95). In a subgroup analysis among patients with resectable HCC, supportive care showed significantly worse survival over TACE (HR for mortality, 6.47; 95% CI, 2.14-19.56) and curative intent (HR for mortality, 16.23; 95% CI, 1.92-136.83).
  
  
  CONCLUSIONS
  Curative treatment seems to have a better survival benefit in comparison with other treatment modalities in elderly HCC patients.
authors.forename: Seung Dae
authors.initials: SD
authors.lastname: Kang
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Jwa
authors.forename: Yun Ho
authors.initials: YH
authors.lastname: Choi
authors.forename: Tae Jun
authors.initials: TJ
authors.lastname: Song
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Bae
authors.forename: Nam Hoon
authors.initials: NH
authors.lastname: Kim
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: June Sung
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D010166:Palliative Care; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000431:Ethanol