Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?

Table 1 Summary table of meta-analyses comparing outcomes of hepatectomy for hepatocellular carcinoma in the elderly and young populations

Authors (year)	Characteristics of included studies	Outcome measures and results	Conclusions
Hung et al[38], (2015)	23 studies included in total 18 studies on hepatectomy for hepatocellular carcinoma (6341 patients)	Short-term outcomes Treatment complications: Comparable between the elderly and younger groups Long-term outcomes 1-, 3-, 5-yr disease-free and overall survival: Increased 1-yr overall survival in the elderly compared to the younger group Comparable 3- and 5-yr survival, disease-free survival	Hepatectomy, transarterial chemoembolization and radiofrequency ablation are safe and effective for elderly hepatocellular carcinoma patients Similar success compared to younger patients Optimal strategy depends on patient and tumor characteristics (evaluation of cancer stage and general condition is important)
Mizuguchi et al[37], (2014)	16 studies included in total 5 studies on hepatectomy for hepatocellular carcinoma (1932 patients)	Short-term outcomes Morbidity and mortality: No significant differences between the elderly and younger groups	Outcome of hepatectomy depends on tumor type (hepatocellular carcinoma vs colorectal metastatic cancer) Hepatectomy is indicated in older hepatocellular carcinoma patients
Zhou et al[9], (2013)	28 studies included in total 11 studies on hepatectomy for hepatocellular carcinoma (3560 patients)	Short-term outcomes Morbidity and mortality: No significant differences between the elderly and younger groups Long-term outcomes 5-yr disease-free and overall survival: No significant differences between the elderly and younger groups	Similar overall morbidity and mortality in elderly and young patients Analysis should be interpreted with caution as elderly mortality after hepatectomy has been reported to be higher in the presence of cirrhosis Age alone should not be a contraindication to hepatectomy