Nishikawa Hiroki, Kimura Toru, Kita Ryuichi, Osaki Yukio
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan.
J Cancer. 2013 Sep 14;4(8):635-43. doi: 10.7150/jca.7279.
An aging society means that the number of elderly patients with cancer is predicted to rise in the future. Hepatocellular carcinoma (HCC) usually develops in patients with hepatitis B virus infection, hepatitis C virus infection, or alcoholic liver disease. The risk of developing HCC is also known to be age-dependent and elderly patients sometimes present with HCC. The increased longevity of the population thus means that more elderly HCC patients are to be expected in the coming years. In general, many elderly patients are not receiving optimal therapy for malignancies, because it is often withheld from them because of perceived minimal survival advantage and the fear of potential toxicity. Comprehensive data with regard to treatment of elderly patients with HCC are currently limited. Furthermore, current guidelines for the management of HCC do not satisfy strategies according to age. Thus, there is urgent need for investigation of safety and clinical outcomes in elderly patients who receive therapy for HCC. In this review, we primarily refer to current knowledge of clinical characteristics and outcome in elderly patients with HCC who underwent different treatment approaches (i.e., surgical resection, liver transplantation, locoregional therapies, and molecular-targeting therapy).
老龄化社会意味着预计未来老年癌症患者的数量将会增加。肝细胞癌(HCC)通常发生于感染乙型肝炎病毒、丙型肝炎病毒或患有酒精性肝病的患者。已知发生HCC的风险也与年龄相关,老年患者有时会出现HCC。因此,人口寿命的延长意味着未来几年将会出现更多的老年HCC患者。一般来说,许多老年患者没有接受针对恶性肿瘤的最佳治疗,因为由于认为生存优势极小以及担心潜在毒性,这种治疗往往不提供给他们。目前关于老年HCC患者治疗的综合数据有限。此外,目前的HCC管理指南并不满足根据年龄制定的策略。因此,迫切需要对接受HCC治疗的老年患者的安全性和临床结局进行研究。在本综述中,我们主要参考了接受不同治疗方法(即手术切除、肝移植、局部区域治疗和分子靶向治疗)的老年HCC患者的临床特征和结局的现有知识。