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Management and prognosis of hepatocellular carcinoma in the elderly: Results of an in‐field multicenter cohort study
Author(s) -
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
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13392
Subject(s) - medicine , hepatocellular carcinoma , liver cancer , cohort , liver function , logistic regression , cancer , stage (stratigraphy) , survival analysis , gastroenterology , cohort study , paleontology , biology
Aims This multicentre cohort study evaluated the role of ageing on clinical characteristics, treatment allocation and outcome of new hepatocellular carcinomas ( HCC s), 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.