Skip to main content
  • Meeting abstract
  • Open access
  • Published:

Decision making in elderly HCC

Background

The decision making process in hepato-cellular carcinoma (HCC) relies on multiple factors. Hepatic surgery, in fact, has to take into consideration a patient’s general medical condition, performance status, underlying liver disease, functional hepatic reserve. All these factors affect hepatic metabolism, flux and regeneration mechanism conditioning future liver remnant volume. What is more, hepatic regeneration is delayed, even if not completely impaired, in the elderly. Nevertheless age is not always properly taken into account.

Materials and methods

The aim of this retrospective study is to evaluate the usefulness of Barcelona Liver Cancer Clinic (BCLC) in the treatment of HCC, comparing our treatment decision and the BCLC algorithm indications, especially considering elderly patients. In 164 patients affected by HCC treatment the choice was compared with that proposed by BCLC. We performed a univariate analysis considering factors such as sex, age, Child, Okuda, PST and ethiology which influence the decision making process.

Results

We did not find statistically significative evidence for all the parameters analysed but for age and performance status test (PST) we have had different findings.

In patients submitted to surgery the average age was 63.00 (IQR 56.75-67.75), while patients not surgically treated were of an average age of 68.00 (IQR 60.00-73.00). In this case the χ2 showed a significative difference (p =0.03) demonstrating that the younger patients were submitted more easily to surgery when compared with the older group. Analysing PST groups (0, 1, 2) we found that patients submitted to surgery were belonged to an earlier PST class by contrast with those who underwent other therapies, with a statistically significative p value = 0.04.

Conclusions

Analysing our conduct in treating HCC, we can conclude that our decision making process especially in surgical indication has been influenced by factors regarding the patients, for instance age and PST which require the multidisciplinary HCC team to pay more attention.

References

  1. Vauthey J-N, Dixon E: Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. HPB. 2010, 12: 289-299.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Llovet JM, Bru C, Bruix J: Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999, 19: 329-338. 10.1055/s-2007-1007122.

    Article  CAS  PubMed  Google Scholar 

  3. Grieco A, Pompili M: Prognostic factors for survival in patients with early-intermediate hepatocellular carcinoma undergoing non-surgical therapy: comparison of Okuda, CLIP, and BCLC staging systems in a single Italian centre. Gut. 2005, 54: 411-418. 10.1136/gut.2004.048124.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Sofia M, La Greca G: Analysis of BCLC treatment indications. Have BCLC modified our choice of treatment in HCC patients? A retrospective study. Hepatogastroenterology. 2009, 56: 1090-1094.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M A Trovato.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Trovato, M.A., Pesce, A., Scilletta, R. et al. Decision making in elderly HCC. BMC Geriatr 11 (Suppl 1), A63 (2011). https://0-doi-org.brum.beds.ac.uk/10.1186/1471-2318-11-S1-A63

Download citation

  • Published:

  • DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/1471-2318-11-S1-A63

Keywords