Management and prognosis of hepatocellular carcinoma in the elderly: Results of an in-field multicenter cohort study

Mauro Borzio, Elena Dionigi, Alessandro Vitale, Angelo Rossini, Massimo Marignani, Fabio Fornari, Susanna Vicari, Ilario De Sio, Fabio Farinati, Emanuela Bertolini, Filippo Oliveri, Gioacchino Leandro, Giampiero Francica, Mario Mitra, Barbara Omazzi, Sergio Boccia, Andrea Salmi, Anna Toldi, Rodolfo Sacco

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1184-1192
Number of pages9
JournalLiver International
Volume37
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Journal Article

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