XXXX in the elderly.

@entity1 @entity157 @entity2857 @entity5
Mean age of @entity157 ( @entity157 ) @entity1 has been progressively increasing over the last decades and ageing of these @entity1 is becoming a real challenge in every day clinical practice. Unfortunately, international guidelines on @entity157 management do not address this problem exhaustively and do not provide any specific recommendation. We carried out a literature search in MEDLINE database for studies reporting on epidemiology, clinical characteristics and treatment outcome of @entity157 in elderly @entity1 . Available data seem to indicate that in elderly @entity1 the outcome of @entity157 is mostly influenced by liver function and @entity5 stage rather than by age and the latter should not influence treatment allocation. Age is not a risk for resection and older @entity1 with resectable @entity157 and good liver function could gain benefit from surgery. Mild comorbidities do not seem a contraindication for surgery in aged @entity1 . Conversely, major resection in elderly, even when performed in experienced high-volume centres, should be avoided. Both percutaneous ablation and transarterial chemoembolization are not contraindicated in aged @entity1 and safety profile of these procedures is acceptable. @entity2857 is a viable option for advanced @entity157 in elderly provided that a careful evaluation of concomitant comorbidities, particularly cardiovascular ones, is taken into account. Available data seem to suggest that in either elderly and younger, treatment is a main predictor of outcome. Consequently, a nihilistic attitude of physicians towards under- or no-treatment of aged @entity1 should not be longer justified.
