Financial support: This work was supported by Health and Labour Sciences Research Grants (Research on Hepatitis) from the Ministry of Health, Labour and Welfare of Japan.
Characteristics of elderly hepatitis C virus-associated hepatocellular carcinoma patients
Article first published online: 22 JAN 2013
© 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 2, pages 357–364, February 2013
How to Cite
Kumada, T., Toyoda, H., Kiriyama, S., Tanikawa, M., Hisanaga, Y., Kanamori, A., Tada, T. and Tanaka, J. (2013), Characteristics of elderly hepatitis C virus-associated hepatocellular carcinoma patients. Journal of Gastroenterology and Hepatology, 28: 357–364. doi: 10.1111/jgh.12057
Declaration of conflict of interest: The authors report no conflicts of interest.
- Issue published online: 22 JAN 2013
- Article first published online: 22 JAN 2013
- Accepted manuscript online: 28 NOV 2012 07:12AM EST
- Manuscript Accepted: 14 OCT 2012
- Ministry of Health, Labour and Welfare of Japan
- alanine aminotransferase (ALT);
- alpha-fetoprotein (AFP);
- average integration value of ALT;
- elderly patient;
- hepatitis C virus (HCV);
- hepatocellular carcinoma (HCC);
- platelet count;
- propensity score
Background and Aim
The average age of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients has been rising in Japan. We evaluate characteristics of HCV-positive patients who develop HCC in older age to determine an optimal surveillance strategy.
A total of 323 patients with three or more years of follow-up before HCC diagnosis and 323 propensity-matched controls without HCC were studied. HCC patients were classified into four groups according to age at the time of HCC diagnosis: group A (≤ 60 years, n = 36), group B (61–70 years, n = 115), group C (71–80 years, n = 143), and group D (> 80 years, n = 29). Clinical and laboratory data were compared.
Platelet counts were significantly higher in the older groups at HCC diagnosis (P < 0.0001). The rate of platelet counts decline was lower in older groups (P = 0.0107). The average integration value of serum alanine aminotransferase (ALT) in groups A, B, C, and D were 80.9 IU/L, 62.3 IU/L, 59.0 IU/L, and 44.9 IU/L, respectively (P < 0.0001). In older patients (≥ 65 years old), cirrhosis and average integration value of ALT were significantly associated with hepatocarcinogenesis, but platelet count was not.
Elderly HCV-positive patients (≥ 65 years old) with low ALT values developed HCC regardless of their platelet counts. These findings should be taken into account when designing the most suitable HCC surveillance protocol for this population.