Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Medical School, Gwanjgu, Republic of Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Medical School, Gwanjgu, Republic of Korea
In Vivo. 2019 Sep-Oct;33(5):1411-1420. doi: 10.21873/invivo.11618.
Recent studies report a significant age-specific increase in hepatocellular carcinoma (HCC) development among persons over 75 years old. Therefore, there is an urgent need to determine the optimal treatment strategy in elderly patients with HCC. This systemic review examines the clinical characteristics, efficacy, and safety of first-line treatment modalities. The literature was searched regarding epidemiology and clinical outcomes in elderly patients (age ≥75 years) undergoing first-line treatment for HCC. Causative or comorbid conditions of HCC in elderly patients differed from those in younger patients. Radiofrequency ablation may be effective and safe in early stages. Surgical resection may also be feasible in the early stages for selected patients. Transarterial chemoembolization may be safe and effective for intermediate HCC, and sorafenib may be feasible in elderly patients with advanced HCC. Prospective randomized trials are needed to establish the treatment strategy for elderly patients with HCC.
最近的研究报告称，75 岁以上人群中肝细胞癌 (HCC) 的发展具有明显的年龄特异性增加。因此，迫切需要确定老年 HCC 患者的最佳治疗策略。本系统评价研究了一线治疗方法的临床特征、疗效和安全性。对接受 HCC 一线治疗的老年患者（年龄≥75 岁）的流行病学和临床结局相关文献进行了检索。老年患者 HCC 的病因或合并症与年轻患者不同。射频消融在早期可能是有效和安全的。手术切除在早期也可能对选定的患者可行。经动脉化疗栓塞术可能对中期 HCC 安全有效，索拉非尼可能对晚期 HCC 的老年患者可行。需要前瞻性随机试验来确定老年 HCC 患者的治疗策略。
