Unveiling the True Culprit: Age, Not Comorbidity, Behind Poorer Survival in Liver Cancer
A groundbreaking study challenges conventional wisdom, revealing that age, not comorbidity, is the primary factor driving poorer survival rates in patients with hepatocellular carcinoma (HCC), the most common form of liver cancer. This research, published in the Clinical Gastroenterology and Hepatology journal, highlights the critical role of age in predicting outcomes, even among those with early-stage cancer or receiving potentially curative treatments.
The Study's Findings: Age as the Decisive Factor
Researchers analyzed data from 2,002 patients diagnosed with HCC, revealing a median age of 61 and a male predominance of 76%. Despite the majority being male, only 21% had early-stage disease, and the overall median survival was a concerning 15.7 months. The key discovery? Age was a stronger predictor of poorer survival than comorbidity.
The study employed sophisticated statistical models, including multivariable logistic regression and Cox proportional hazards models, to analyze the impact of age and comorbidity. Interestingly, patients with higher comorbidity were more likely to receive curative treatment, contrary to expectations. However, when it came to survival, age emerged as the decisive factor.
- Patients aged 65 or older had significantly worse overall survival (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.06–1.47) compared to younger patients.
- In contrast, comorbidity burden showed no significant relationship with mortality (HR, 0.92; 95% CI, 0.77–1.09).
This finding held true across various subgroups, including those with early-stage cancer and those receiving potentially curative therapy.
Implications for Liver Cancer Prognosis and Care
The authors emphasize the importance of considering age as a critical prognostic factor in HCC. They advocate for further research to refine prognostic tools and screening criteria, acknowledging that the interplay between aging and liver cancer progression is complex. By understanding the dominant role of age, healthcare professionals can better prepare patients and their families for the challenges ahead.
Source:
Kanneganti M et al. (2025). Older age but not comorbidity is associated with worse survival in patients with hepatocellular carcinoma. Clinical Gastroenterology and Hepatology. 23(8): 1377-86.
