While the number of elderly patients with liver cancer is increasing, a study has found that the prognosis during treatment intervention is similar to that of non-elderly patients. In particular, in the case of advanced liver cancer accompanied by vascular invasion or liver metastasis, 40.2% of elderly patients who did not receive treatment reached 40.2%, indicating that awareness of the need for treatment should be improved.
On the 2nd, the Korean Liver Cancer Society held the 7th Liver Cancer Day ceremony at the Westin Chosun Hotel and presented a study on appropriate liver cancer treatment in the aging era.
In a recent large-scale study using data from the National Health Insurance Service, the incidence of liver cancer decreased in all age groups, while in those aged 80 and older, it continued to increase at an average annual rate of 9.0% from 70.0 per 100,000 people in 2008 to 160.2 per 100,000 people in 2018.
It has been reported that the predicted crude incidence rate will also gradually increase and will quadruple by 2028 compared to 2008 (521 per 100,000 person-years in 2008 → 2055 in 2028).
On this day, the society emphasized the seriousness of the problem and the justification for intervention in elderly patients through the liver cancer registration project committee’s random liver cancer registration project data analysis.
As a result of liver cancer registration project data analysis, among 15,186 patients newly diagnosed with liver cancer from 2008 to 2017, elderly patients aged 65 or older accounted for 38.4%.
In the elderly, hepatitis B-associated liver cancer accounts for a small percentage (29.7% vs. 68.1%), but hepatitis C (18.1% vs. 6.1%), alcoholic liver disease (16.8% vs. 7.9%), and other liver diseases compared to non-elderly people. (28.0% vs. 10.0%) Associated liver cancer was higher.
In this regard, Lee Han-ah, a member of the planning committee (division of gastroenterology at Ewha Womans University Mokdong Hospital), said, “In the liver cancer registration project data analysis, it was found that elderly patients with liver cancer did not receive treatment following being diagnosed with liver cancer more than non-elderly patients (25.5% vs. 16.9%). “In particular, in the case of advanced liver cancer accompanied by vascular invasion or liver metastasis, 40.2% of elderly patients who did not receive treatment were concerned.”
“Even for early liver cancer, which can be cured with hepatectomy or radiofrequency ablation, elderly patients were more likely to receive local treatment, carotid artery chemoembolization, than non-elderly patients,” he said. However, with the recent increase in life expectancy of liver cancer patients, it is necessary to reconsider this treatment trend.”
Aggressive liver cancer treatment is known to help improve survival rates regardless of age, so the society judged that it was not appropriate to give up treatment just because of old age. In fact, in the liver cancer registration project data analysis, the survival rate of elderly patients who received treatment was significantly higher than that of patients who did not receive treatment, confirming the importance of active treatment.
Member Lee said, “In the liver cancer registration project data analysis conducted by the society, it was found that there was no difference in treatment results between elderly and non-aged liver cancer patients, as in other foreign studies.” There is no difference in the survival rate following surgery or radiofrequency ablation, which is an effective treatment, compared to that of non-elderly patients,” insisting on the need for active treatment.
“Especially, there was no difference between the elderly and non-elderly patients in the survival rate following carotid arterial chemoembolization, radiation therapy, or immuno-anticancer drug treatment, even in the stage past early liver cancer,” he said. can be received,” he explained.
“In several studies, there was no difference in the incidence of complications following hyperthermia therapy in elderly and non-elderly patients, so local treatment can be applied to elderly patients who do not have enough surgical resection,” he added. Since there is no difference in the incidence rate, it can be performed in elderly patients, but if the tumors are large or the number is large, radioembolization can be performed considering postoperative complications or safety.”
While many elderly patients diagnosed with advanced liver cancer in the past gave up treatment due to lack of safe and effective systemic therapy, recently, the role of extracorporeal radiation therapy has gradually expanded, and many elderly patients are actually receiving radiation therapy safely.
Commissioner Lee said, “As the era of immuno-anticancer drug treatment has recently opened, it has become possible to significantly reduce tumors and side effects while maintaining quality of life.” necessary,” he said.