Hepatocellular carcinoma management in older adults and its relation with frailty

Frailty, defined as a condition of extreme clinical vulnerability, is a crucial predictor of survival in elderly cancer patients. Frailty is not a specific disease but rather a combination of physical, cognitive, and social factors that compromise the patient’s ability to effectively respond to stressful situations. The majority of patients diagnosed with hepatocellular carcinoma (HCC) are over 65 years old, making it essential to also assess comorbidities and conditions that may predispose to frailty, as these can influence prognosis. Therefore, identifying a clinical tool to standardize the concept of the “frail elderly patient” is essential to ensure an appropriate medical approach for this population. In this review, we examine various frailty assessment tools and evaluate their application in different therapeutic and management settings for elderly patients with HCC. Understanding the impact of frailty in elderly patients with HCC can help optimize clinical management, thereby reducing resource waste for the healthcare system and minimizing stress factors for the patient.