Impact of aging on primary liver cancer : epidemiology, pathogenesis and therapeutics

Aging involves progressive physiological and metabolic reprogramming to adapt to gradual deterioration of organs and functions. This includes mechanisms of defense against pre-malignant transformations. Thus, certain tumors are more prone to appear in elderly patients. This is the case of the two most frequent types of primary liver cancer, i.e., hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). Accordingly, aging hallmarks, such as genomic instability, telomere attrition, epigenetic alterations, altered proteostasis, mitochondrial dysfunction, cellular senescence, exhaustion of stem cell niches, impaired intracellular communication, and deregulated nutrient sensing can play an important role in liver carcinogenesis in the elders. In addition, increased liver fragility determines a worse response to risk factors, which more frequently affect the aged population. This, together with the difficulty to carry out an early detection of HCC and iCCA, accounts for the late diagnosis of these tumors, which usually occurs in patients with approximately 60 and 70 years, respectively. Furthermore, there has been a considerable controversy on what treatment should be used in the management of HCC and iCCA in elderly patients. The consensus reached by numerous studies that have investigated the feasibility and safety of different curative and palliative therapeutic approaches in elders with liver tumors is that advanced age itself is not a contraindication for specific treatments, although the frequent presence of comorbidities in these individuals should be taken into consideration for their management.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

Aging - 13(2021), 19 vom: 11. Okt., Seite 23416-23434

Sprache:

Englisch

Beteiligte Personen:

Macias, Rocio I R [VerfasserIn]
Monte, Maria J [VerfasserIn]
Serrano, Maria A [VerfasserIn]
González-Santiago, Jesús M [VerfasserIn]
Martín-Arribas, Isabel [VerfasserIn]
Simão, André L [VerfasserIn]
Castro, Rui E [VerfasserIn]
González-Gallego, Javier [VerfasserIn]
Mauriz, José L [VerfasserIn]
Marin, Jose J G [VerfasserIn]

Links:

Volltext

Themen:

Aging
Cholangiocarcinoma
Fragility
Hepatocarcinoma
Journal Article
Research Support, Non-U.S. Gov't
Review
Senescence

Anmerkungen:

Date Completed 08.02.2022

Date Revised 03.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.18632/aging.203620

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM331748878