Advanced age was
found in the current study to be a poor prognostic factor across all treatable patients, SB203580 purchase even those with very early or early stage HCC. Indeed, the 4-year survival rate was 28.9% for patients aged 70 years or more, compared with 57.4% for younger patients. The mean age of patients with HCC was 65.8 years, and most of these (68/88, 77.3%) were positive for anti-HCV. The mean age of HCV-related HCC patients in Taiwan has been previously reported as 65.1 years.35 In Japan it was found that approximately 80% of HCC patients were anti-HCV positive, and more than 60 years old.3 Teratani et al. reported that the 1-yearand 3-year survival rate of patients older than 70 years receiving percutaneous ethanol injections was 83% and 52%, respectively. By contrast, the 1-year and 3-year survival rate of patients younger than 70 years was 90% and 65%, respectively.36 Similarly, an Italian study Daporinad concluded that elderly patients (aged ≥ 70 years) with HCC have a worse prognosis than younger patients. This difference seems to be a consequence of under-treatment in the older patients.37 On the other hand, a Japanese study reported that it was an advanced stage of HCC, rather than advanced age, that influenced survival rates in
elderly patients (aged ≥ 80 years). That study found the 1-year and 3-year survival rates for an elderly group to be 54.1% and 28.1%, respectively, and for a non-elderly group to be 69.9% and 43.2%, respectively.17 The survival of elderly patients with HCC is reported to be affected by several factors, including high serum levels of AFP, advanced
stage, and the presence of concomitant underlying disease.18,38 In the current study, elderly patients (> 70 years old) with very early or early stage HCC who received curative treatment had 上海皓元医药股份有限公司 a 4-year survival rate of 57.1%, higher than previously reported. This shows that early detection and curative treatment of HCC are effective in the elderly, and that community-based screening of this population is warranted. Alanine aminotransferase (ALT) < 80 IU/L was a prognostic factor in patients ≥ 70 years old. We further analyzed the correlation regression coefficient between ALT < 80 IU/L and other clinical factors. ALT < 80 IU/L was correlated with low platelet count (correlation regression coefficient: 0.585). Hence, ALT < 80 might reflect advanced fibrosis, which could explain a poor prognosis in patients aged over 70 years. Another factor found by the current study to be important in patients older than 70 years was a platelet count of < 100 × 103/mm3. Thrombocytopenia, indicating advanced LC, has been reported to be a poor prognostic factor for curative treatments that include resection,39 radiofrequency ablation,40 and percutaneous ethanol injection therapy.41 In the current study, the 3-year survival rate of elderly patients with a low platelet count (< 100 × 103/mm3) was only 10%.