Active treatments are a rational approach for hepatocellular carcinoma in elderly patients

Suda, Takafumi; Nagashima, Aiko; Takahashi, Shyunsaku; Kanefuji, Tsutomu; Kamimura, Kenya; Tamura, Yasushi; Takamura, Masaaki; Igarashi, Masato; Kawai, Hirokazu; Yamagiwa, Satoshi; Nomoto, Minoru; Aoyagi, Yoshinobu

doi:10.3748/wjg.v19.i24.3831

Cited by 13 publications

(21 citation statements)

References 12 publications

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“…Consequently, the number of operations performed on elderly patients is increasing. In the Japanese population, the overall incidence of hepatocellular carcinoma (HCC) has decreased due to the decreasing incidence of hepatitis C virus (HCV), while the rate of HCC in the absence of HCV, and of liver metastasis from colon cancer, has increased (1–3). The average age of patients undergoing hepatic resection has increased due to population aging (1).…”

Section: Introductionmentioning

confidence: 99%

“…In the Japanese population, the overall incidence of hepatocellular carcinoma (HCC) has decreased due to the decreasing incidence of hepatitis C virus (HCV), while the rate of HCC in the absence of HCV, and of liver metastasis from colon cancer, has increased (1–3). The average age of patients undergoing hepatic resection has increased due to population aging (1). Several studies have reported on the usefulness and safety of hepatic resection for elderly patients: No differences in complications or prognosis were observed between this population and younger patients (2,3).…”

Section: Introductionmentioning

confidence: 99%

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Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Iida

Kaibori

Matsui

et al. 2016

Molecular and Clinical Oncology

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The aim of the present study was to evaluate the clinicopathological features, benefits and problems associated with hepatic resection of hepatocellular carcinoma in patients aged ≥80 years. Between 2006 and 2013, hepatic resection was performed in 395 hepatocellular carcinoma patients, including 351 patients aged <80 years and 44 patients aged ≥80 years. Clinicopathological examination revealed that the tumor size was significantly larger among patients of ≥80 years of age. However, recurrence-free and cumulative survival rates were similar between the two age groups. The occurrence of post-operative complications was an independent risk factor for survival among patients ≥80 years of age. In addition, the albumin level was identified as a risk factor for post-operative complications. The post-operative transition towards an improvement in the albumin level in the ≥80 years group was significantly lower compared with the <80 years group. It was revealed that hepatic resection was feasible for elderly patients. However, the post-operative improvement in the albumin levels was less marked among patients ≥80 years of age, and lower albumin levels were associated with post-operative complications and prognosis. Therefore, elderly patients undergoing hepatic resection should receive peri-operative management including special nutrition.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Iida

Kaibori

Matsui

et al. 2016

Molecular and Clinical Oncology

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“…Suda et al [14] evaluated the survival of 740 patients who received various treatments for HCC between 1983 and 2011 and concluded that a therapeutic approach for HCC should not be restricted due to patient age.…”

Section: Treatment Flow Chart Of Hcc Overall and In Elderly Patientsmentioning

confidence: 99%

Is the efficacy of sorafenib treatment in patients with hepatocellular carcinoma affected by age?

Cabibbo

Cammà

Craxı̀

2013

Expert Review of Anticancer Therapy

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Cancer is a prevalent disease in the elderly population and hepatocellular carcinoma (HCC) is a major health problem among all tumors. Curative treatments for early-stage include liver transplantation, resection and percutaneous ablation. Transarterial chemoembolization (TACE) and sorafenib, classified as non-curative treatments, can improve survival for patients with intermediate and advanced tumors, respectively. Even if the incidence of HCC progressively increases with advanced age in all populations, reaching a peak at 70 years, few reports concerning correct management of HCC in elderly patients exist. Moreover, data from large randomized controlled trials (RCT) poorly reflect the elderly population that is often quantitatively and qualitatively underrepresented, as a result of the presence of tight enrolment criteria. The aim of this brief review is to highlight the main concerns, pitfalls and warnings regarding the management of HCC in elderly patients, with particular focus on systemic therapy with sorafenib.

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“…However, the treatments for HCC have progressed significantly over the last few years and Mirici-Cappa et al (5) demonstrated that the overall applicability of radical or effective HCC treatment may not be affected by age. Moreover, Suda et al (2) suggested that the therapeutic approach to HCC should not be restricted by patient age.…”

Section: Introductionmentioning

confidence: 99%

“…HCC principally develops on a background of chronic liver disease, particularly cirrhosis caused by hepatitis C or hepatitis B virus infection (1). In Japan, the median age of patients with HCC has been increasing gradually since 1986 (2). Elderly cancer patients often present with multiple comorbidities and age-related changes in the pharmacokinetics and pharmacodynamics of anticancer drugs that may affect chemotherapeutic regimens (3).…”

Section: Introductionmentioning

confidence: 99%

Comparison of hepatic arterial infusion chemotherapy and sorafenib in elderly patients with advanced hepatocellular carcinoma: A case series

Nemoto

Matsuda

Nosaka

et al. 2014

Molecular and Clinical Oncology

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Sorafenib and hepatic arterial infusion chemotherapy (HAIC) are both indicated for unresectable hepatocellular carcinoma (HCC). In this study, we compared the efficacy and safety of HAIC to that of sorafenib in elderly patients with HCC. Eligible patients included those aged ≥70 years, with histologically or clinically confirmed advanced HCC. A total of 12 patients received sorafenib (800 mg per day) and 8 patients received HAIC with 5-fluorouracil (300 mg/m on days 1-5 and 8-12) with or without cisplatin (20 mg/m on days 1 and 8), with interferon-α (3 times per week for 4 weeks). The response rate was significantly higher in patients treated with HAIC (37.5%) compared to that in patients treated with sorafenib (no response). The median overall survival (18.6 and 11.7 months) and progression-free survival (4.0 and 5.0 months) were similar between the sorafenib and HAIC groups, respectively. In the sorafenib group, 58.3% of the patients discontinued treatment compared to none in the HAIC group. The most frequent adverse event leading to discontinuation of sorafenib was anorexia. Similar to sorafenib, HAIC appears to be a feasible treatment and may also have the advantage of an adequate safety profile for elderly patients with advanced HCC. Further study of HAIC in a larger population of elderly patients is required to assess its potential as an alternative to sorafenib for HCC.

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Active treatments are a rational approach for hepatocellular carcinoma in elderly patients

Abstract: These results suggest that a therapeutic approach for HCC should not be restricted due to patient age.

Cited by 13 publications

References 12 publications

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Assessing the feasibility of clinicopathological features of hepatic resection for hepatocellular carcinoma in patients over 80 years of age

Is the efficacy of sorafenib treatment in patients with hepatocellular carcinoma affected by age?

Comparison of hepatic arterial infusion chemotherapy and sorafenib in elderly patients with advanced hepatocellular carcinoma: A case series

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