Division of Gastroenterology, Department of Medicine, Kurume University Medical Center.
The aim of this study was to evaluate the long-term outcome of elderly patients with hepatocellular carcinoma aged 75 years or older.
The study included 422 patients with hepatocellular carcinoma, who were divided into two age groups: 75 years or older (n=140) and younger than 75 (n=282). Outcomes were compared between the two groups.
The number of elderly patients treated with supportive care alone (33 patients; 24%) was significantly higher than younger patients (30 patients; 11%, p<0.01). The 1-, 3-, 5-, and 7-year overall survival rates of the elderly patients (81%, 55%, 39%, and 23%, respectively) were worse than those of younger patients (85%, 64%, 49%, and 36%, respectively, p=0.042). However, the overall survival rate of the elderly group after excluding 63 patients treated with supportive care alone, was similar to that of the younger group (p=0.615). Multivariate analysis identified age, total bilirubin levels, albumin levels, serum DCP levels, tumor size, number of HCC nodules, vascular invasion, extra-hepatic metastasis, and treatment modality as independent and significant factors of overall survival.
Advanced age is a negative prognostic factor in patients with hepatocellular carcinoma due to the tendency for frequent use of conservative treatment rather than locoregional or surgical treatment.