Hepatocellular carcinoma in elderly patients: challenges and solutions

Brunot, Angélique; Sourd, Samuel Le; Pracht, Marc; Edeline, Julien

doi:10.2147/jhc.s101448

Cited by 42 publications

(35 citation statements)

References 67 publications

(88 reference statements)

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“…9,10,12 This might be related to delayed development of HCC among viral hepatitis, especially in HCV. 13 In our study, the most important risk factor for HCC was HCV, which is consistent with most of the previous studies. [8][9][10] However, cryptogenic HCC was the second common after hepatitis C, which is in contrast to a previously reported local study conducted in the same institute where it found that HBV was the second common after HCV.…”

Section: Discussionsupporting

confidence: 93%

The prevalence and associated factors of viral hepatitis and cryptogenic related hepatocellular carcinoma at King Abdulaziz Medical city-Riyadh

Alhaqbani

Almusalam

Alnadhari

et al. 2019

Int J Community Med Public Health

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Background: Worldwide, viral hepatitis is the major risk factor for HCC with hepatitis B (HBV) being more than hepatitis C (HCV). Saudi Arabia is one of the endemic areas of viral hepatitis. Cryptogenic HCC is thought to arias from unknown causes of liver cancers. Thus, the purpose of this study was to find the prevalence of viral and cryptogenic HCC in King Abdulaziz Medical City-Riyadh (KAMC-R).Methods: A retrospective chart review was performed for all HCC patients diagnosed between 2010 to 2017 at KAMC-R. Information regarding age, gender, comorbidity, alcohol consumption, serology tests, liver enzymes, body mass index, model for end-stage liver disease score, alpha-fetoprotein and Child-Turcotte-Pugh score were included. The Chi-square test was used to determine the differences between categorical data. A p<0.05 was considered statistically significant.Results: Total of 294 patients with HCC charts were reviewed. HCV and HBV were found in 42.85% and 20.74% of the patients, respectively. Co-infection with HBV and HCV were reported in 1.7% whereas cryptogenic HCC was found in 32.65% of the patients. High BMI and DLP were noticeably higher in cryptogenic group (p=0.045 and p=0.022 respectively). Multiple lesions were noticed more in HCV group whereas single lesion was more in the cryptogenic group (p=0.0343). Also, large lesions (>5 cm) were remarkably found more in cryptogenic HCC whereas small lesions were more in HCV group (p=0.006).Conclusions: Hepatitis C was the major risk factor associated with HCC, followed by Cryptogenic HCC. High BMI and DLP were common features of cryptogenic HCC.

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Section: Discussionsupporting

confidence: 93%

The prevalence and associated factors of viral hepatitis and cryptogenic related hepatocellular carcinoma at King Abdulaziz Medical city-Riyadh

Alhaqbani

Almusalam

Alnadhari

et al. 2019

Int J Community Med Public Health

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“…HCC is the second most common cause of cancer death world‐wide, with poorly understood underlying etiology. In this study, we provide further insight into factors that may contribute to the underlying genetic risk of developing HCC as well as those that may determine how aggressive course the disease takes.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatocellular carcinoma (HCC) is the fifth most-common cancer and the second most common cause of cancer-related death world-wide. 1 Well known risk factors for HCC include hepatitis B (HBV) and C (HCV) viral infections, alcoholic cirrhosis, and non-alcoholic fatty liver disease. However, much less is known about the genetic factors, which generally have been limited to rare inborn errors in metabolism.…”

Section: Introductionmentioning

confidence: 99%

Two BRM promoter polymorphisms predict poor survival in patients with hepatocellular carcinoma

Pašić

Wong

Lee

et al. 2017

Molecular Carcinogenesis

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Funding informationThe Alan B. Brown Chair in Molecular Genomics; The Posluns Family Fund Polymorphisms in the promoter of the BRM gene, a critical subunit of the chromatin remodeling SWI/SNF complex, have previously been implicated in risk and prognosis in Caucasian-predominant lung, head and neck, esophageal, and pancreatic cancers, and in hepatocellular cancers in Asians. We investigated the role of these polymorphisms in hepatocellular carcinoma (HCC) risk and prognosis. HCC cases were recruited in a comprehensive cancer center while the matched controls were recruited from family practice units from the same catchment area. For risk analyses, unconditional logistic regression analyses were performed in HCC patients and matched healthy controls.Overall survival analyses were performed using Cox proportional hazard models, Kaplan-Meier curves, and log-rank tests. In 266 HCC cases and 536 controls, no association between either BRM promoter polymorphism (BRM-741 or BRM-1321) and risk of HCC was identified (P > 0.10 for all comparisons). There was significant worsening of overall survival as the number of variant alleles increased: BRM-741 per variant allele adjusted hazards ratio (aHR) 5.77, 95% confidence interval (CI) 2.89-11.54 and BRM-1321 per variant allele aHR 4.09, 95%CI 2.22-7.51. The effects of these two polymorphisms were at least additive, where individuals who were double homozygotes for the variant alleles had a 45-fold increase in risk of death when compared to those who were double wild-type for the two polymorphisms. Two BRM promoter polymorphisms were strongly associated with HCC prognosis but were not associated with increased HCC susceptibility. The association was strongest in double homozygotes for the allele variants. K E Y W O R D S

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“…As liver resection represents the mainstay of treatment in non-metastatic HCC [32][33][34] , several studies aimed to investigate the difference in outcomes between young and old HCC patients. Therefore, data have proven the safety and feasibility of liver resection in appropriately selected patients aged not only more than 70 years, but, in some cases, even more than 80 years [35][36][37][38] .…”

Section: Liver Resection and Agementioning

confidence: 99%

Frailty and Liver resection: where do we stand?

Sioutas¹,

Ziogas²,

Tsoulfas³

2020

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As the world population is continuously aging, the number of older patients requiring liver surgery is also on the rise. Data have shown that age should not be a limiting factor for liver resection, as it cannot accurately predict postoperative outcomes. Instead, frailty can serve as a more reliable measure of the patient's overall health and functional reserves. Several frailty assessment tools have been implemented for preoperative risk stratification before liver surgery, and higher scores have commonly been associated with postoperative morbidity, mortality, and length of hospital stay. However, no consensus has been reached on the most useful screening tool. Future studies should focus on comparing the currently available assessment tools, constructing a liver resection-specific tool, and assessing the role of frailty assessment tools in preoperative patient optimization.

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Hepatocellular carcinoma in elderly patients: challenges and solutions

Cited by 42 publications

References 67 publications

The prevalence and associated factors of viral hepatitis and cryptogenic related hepatocellular carcinoma at King Abdulaziz Medical city-Riyadh

The prevalence and associated factors of viral hepatitis and cryptogenic related hepatocellular carcinoma at King Abdulaziz Medical city-Riyadh

Two BRM promoter polymorphisms predict poor survival in patients with hepatocellular carcinoma

Frailty and Liver resection: where do we stand?

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