Management and prognosis of hepatocellular carcinoma in the elderly: Results of an in‐field multicenter cohort study. (30th March 2017)

• Record Type: Journal Article
• Authors: Borzio, Mauro; Dionigi, Elena; Vitale, Alessandro; Rossini, Angelo; Marignani, Massimo; Fornari, Fabio; Vicari, Susanna; De Sio, Ilario; Farinati, Fabio; Bertolini, Emanuela; Oliveri, Filippo; Leandro, Gioacchino; Francica, Giampiero; Mitra, Mario; Omazzi, Barbara; Boccia, Sergio; Salmi, Andrea; Toldi, Anna; Sacco, Rodolfo
• Is Part Of: Liver international. Volume 37:Number 8(2017)
• Page Start: 1184
• Page End: 1192
• Publication Date: 2017-03-30
• Subjects: cirrhosis -- elderly -- liver neoplasm -- prognosis -- survival; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13392
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Aims: This multicentre cohort study evaluated the role of ageing on clinical characteristics, treatment allocation and outcome of new hepatocellular carcinomas (HCCs), in clinical practice. Material & Methods: 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. Results: 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. Conclusions: 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.