Federico Piera, Giunta Emilio Francesco, Pappalardo Annalisa, Tufo Andrea, Marte Gianpaolo, Attademo Laura, Fabbrocini Antonietta, Petrillo Angelica, Daniele Bruno
Medical Oncology Unit, Ospedale del Mare, 80147 Napoli, Italy.
Department of Precision Medicine, School of Medicine, University of Study of Campania "L. Vanvitelli", 80131 Napoli, Italy.
Pharmaceuticals (Basel). 2021 Mar 8;14(3):233. doi: 10.3390/ph14030233.
Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of "elderly" and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.
肝细胞癌（HCC）是肝脏最常见的原发性肿瘤，在老年人中尤为高发。此外，慢性肝病治疗方法的改进使得可能受HCC影响的老年患者数量增加。关于老年患者HCC的证据很少，并且在临床试验中，老年患者的代表性仍然不足且治疗不够充分。事实上，这一人群是难以管理的复杂患者亚组，尤其是因为存在多种合并症。因此，在临床实践中，治疗方案的选择主要由医生决定，他们往往倾向于不治疗老年患者，以避免发生不良事件的可能性，因为这些不良事件可能会打破他们不稳定的平衡状态。在此背景下，明确老年HCC患者的最佳治疗策略已成为当务之急。本综述的目的是从“老年人”的定义、老年评估和量表入手，概述有关老年患者HCC治疗的现有数据。我们根据巴塞罗那临床肝癌（BCLC）分期系统解释可能的治疗选择及其在老年人群中的可行性。
