AIM:To identify the clinical and prognostic features ofpatients with hepatocellular carcinoma (HCC) aged 80years or more.METHODS:A total of 1310 patients with HCC wereincluded in this study.Ninety-one patients aged 80 yearsor more at the time of diagnosis of HCC were defined asthe extremely elderly group.Two hundred and thirty-fourpatients aged≥50 years but less than 60 years wereregarded as the non-elderly group.RESULTS:The sex ratio (male to female) wassignificantly lower in the extremely elderly group (0.90:1)than in the non-elderly group (3.9:1,P<0.001).The positive rate for HBsAg was significantly lower in theextremely elderly group and the proportion of patientsnegative for HBsAg and HCVAb obviously increased inthe extremely elderly group (P<0.001).There wereno significant differences in the following parameters:diameter and number of tumors,Child-Pugh grading,tumor staging,presence of portal thrombosis or ascites,and positive rate for HCVAb.Extremely elderly patientsdid not often receive surgical treatment (P<0.001) andthey were more likely to receive conservative treatment(P<0.01).There were no significant differences insurvival curves based on the Kaplan-Meier methods incomparison with the overall patients between the twogroups.However,the survival curves were significantlyworse in the extremely elderly patients with stage Ⅰ/Ⅱ,stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparisonwith the non-elderly group.The causes of death did notdiffer among the patients,and most cases died of liver-related diseases even in the extremely elderly patients.CONCLUSION:In the patients with good liver functionsand good performance status,aggressive treatment forHCC might improve the survival rate,even in extremelyelderly patients. AIM: To identify the clinical and prognostic features of patients with hepatocellular carcinoma (HCC) aged 80years or more. METHODS: A total of 1310 patients with HCC wereincluded in this study. Ninety-one patients aged 80 yearsor more at the time of diagnosis of HCC were defined asthe extremely elderly group.Two hundred and thirty-fourpatients aged> 50 years but less than 60 years were regamed as the non-elderly group .RESULTS: The sex ratio (male to female) wassignificantly lower in the extremely elderly group (0.90: 1) than in the non-elderly group (3.9: 1, P <0.001). The positive rate for HBsAg was significantly lower in the extremal elderly group and the proportion of patients negative for HBsAg and HCVAb significantly increased ) .here wereno significant differences in the following parameters: diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb.Extremely elderly patientsdid not of ten receive surgical treatment (P <0.001) and the more likely to receive conservative treatment (P <0.01). There were no significant differences in insurvival curves based on the Kaplan-Meier methods incomparison with the overall patients between the twoproups.However, the survival curves were significantlyworse in the extremely elderly patients with stage Ⅰ / Ⅱ, stage Ⅰ / Ⅱ and Child-Pugh grade A cirrhosis in comparisonwith the non-elderly group.The causes of death did not die in the patients, and most cases died of liver- related diseases even in the extremely elderly patients. CONCLUSION: In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremelyelderly patients.