title: Clinical characteristics and survival outcomes of super-elderly hepatocellular carcinoma patients not indicated for surgical resection.
abstract: OBJECTIVE
  Considering the dramatic increase in average life expectancy during the 20th century throughout the world, the management of elderly patients with cancer has become a global issue. We herein investigated the clinical characteristics and outcomes of super-elderly hepatocellular carcinoma (HCC) patients over 80 years old not indicated for surgical resection.
  
  
  METHODS
  We retrospectively evaluated 206 newly diagnosed HCC patients. The patients were divided into two groups according to their age at inclusion; a super-elderly group (n = 37, ≥80 years) and a younger group (n = 169, <80 years). We compared the clinical characteristics, overall survival (OS) and disease-specific survival (DSS) rates among the two groups. Both univariate and multivariate analyses were performed to identify the factors associated with the OS and DSS.
  
  
  RESULTS
  The proportion of women was higher in the super-elderly group than in the younger group (P = 0.017). There were no significant differences in the OS (P = 0.171) or DSS (P = 0.176) between the two groups. The multivariate analysis revealed that only the Cancer Liver Italian Program score (hazard ratio [HR], 2.972; P < 0.0001; HR, 3.694; P < 0.0001) was independently associated with the OS and DSS. Age was not found to be associated with the OS or DSS according to either the univariate or multivariate analysis.
  
  
  CONCLUSIONS
  There were no significant differences in the OS and DSS rates among the super-elderly HCC patients and younger HCC patients not indicated for surgical resection. An advanced age itself does not restrict the therapeutic approach, even in super-elderly HCC patients not indicated for surgical resection.
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kinoshita
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onoda
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Imai
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Iwaku
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Fushiya
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.affiliation: Division of Gastroenterology and Hepatology, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Tajiri
keywords: clinical characteristics; elderly patients; hepatocellular carcinoma; prognosis