title: Management and prognosis of hepatocellular carcinoma in the elderly: Results of an in-field multicenter cohort study.
abstract: This multicentre cohort study evaluated the role of ageing on clinical characteristics, treatment allocation and outcome of new hepatocellular carcinomas (HCCs), in clinical practice.
  
  
  
  From September 2008, 541 patients >70 years old (elderly group), and 527 ≤70 years old (non-elderly group) with newly diagnosed HCC were consecutively enrolled in 30 Italian centres. Differences in clinical characteristics and treatment allocation between groups were described by a multivariable logistic regression model measuring the inverse probability weight to meet the elderly group. Survival differences were measured by unadjusted and adjusted (by inverse probability weight) survival analysis.
  
  
  
  Elderly patients were mainly females, hepatitis C virus infected and with better conserved liver function (P<.001). At presentation, HCC median size was similar in both groups while, in youngers, HCC was more frequently multinodular (P=.001), and associated with neoplastic thrombosis (P=.009). Adjusted survival analysis showed that age did not predict short-mid-term survival (within 24 months), while it was a significant independent predictor of long-term survival. Moreover, age had a significant long-term survival impact mainly on early HCC stages (Barcelona Clinic for Liver Cancer [BCLC] 0-A), its impact on BCLC B stage was lower, while it was negligible for advanced-terminal stages.
  
  
  
  Age per se does not impact on short-mid-term prognosis (≤24 months) of HCC patients, and should not represent a limitation to its management.
authors.affiliation: UOC Gastroenterologia ed Endoscopia Digestiva, ASST Melegnano e della Martesana, Cernusco sul Naviglio, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Borzio
authors.affiliation: UOC Gastroenterologia ed Endoscopia Digestiva, ASST Melegnano e della Martesana, Cernusco sul Naviglio, Italy.
authors.forename: Elena
authors.identifier: 0000-0002-4393-5063
authors.initials: E
authors.lastname: Dionigi
authors.affiliation: Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche Azienda Università di Padova, Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.affiliation: Dipartimento di Medicina, SSVD di Epatologia, ASST Spedali Civili di Brescia, Cernusco sul Naviglio, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Rossini
authors.affiliation: UOS Malattie delle vie Biliari e del Fegato, UOC malattie dell'Apparato Digerente e del Fegato, AO S.Andrea, Università "Sapienza" Roma, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Marignani
authors.affiliation: Unità di Gastroenterologia ed Epatologia, Ospedale G da Saliceto, Piacenza, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fornari
authors.affiliation: UOS Gastroenterologia Ospedale di Bentivoglio, Bologna, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Vicari
authors.affiliation: Unità di Gastroenterologia, Ospedale Policlinico, Napoli, Italy.
authors.forename: Ilario
authors.initials: I
authors.lastname: De Sio
authors.affiliation: Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche Azienda Università di Padova, Padova, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Farinati
authors.affiliation: U.O. Medicina VI Epatologia e Gastroenterologia, Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bertolini
authors.affiliation: U.O. Epatologia, Azienda Ospedaliero Universitaria Pisana, Ospedale Cisanello, Pisa, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Oliveri
authors.affiliation: UO Gastroenterologia, IRCSS de Bellis, Castellana Grotte, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Leandro
authors.affiliation: Unità di Ecointerventistica, Presidio Ospedaliero Pineta Grande, Castelvolturno, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Francica
authors.affiliation: UO Medicina Interna I, Ospedale "Civico e Benfratelli", Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mitra
authors.affiliation: UOC Gastroenterologia, Ospedale G Salvini, Rho, Milano, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Omazzi
authors.affiliation: UOC Gastroenterologia, Ospedale S.Anna, Ferrara, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Boccia
authors.affiliation: Dipartimento Medicina, Università di Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salmi
authors.affiliation: UO Gastroenterologia Ospedale Valduce, Como, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Toldi
authors.affiliation: UO Gastroenterologia e Malattie del Ricambio, Azienda Ospedaliero Universitaria Pisana, Ospedale Cisanello, Pisa, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Sacco
mesh_terms: D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
keywords: cirrhosis; elderly; liver neoplasm; prognosis; survival