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Peer-reviewedCC BY-NCLiver cancer

The Impact of Frailty in Hepatocellular Carcinoma.

  • Rachael Jacob1,2,3
  • Shirin Salimi1,2,4
  • Dinuli Kamaladasa1
  • Karen Waller2,3
  • Emily He2,3
  • Mark Danta5,6
  • Simone I Strasser1,2
  • Geoff W McCaughan2,7
  • Jacob George2,8
  • Ken Liu1,2,7
8 affiliations
  1. 1AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
  2. 2Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  3. 3Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
  4. 4Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, NSW, Australia.
  5. 5Department of Gastroenterology and Hepatology, St Vincent's Hospital, Sydney, NSW, Australia.
  6. 6School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine, UNSW, Sydney, NSW, Australia.
  7. 7Liver Cancer and Injury Program, Centenary Institute, Sydney, NSW, Australia.
  8. 8Storr Liver Centre, The Westmead Institute for Medical Research, Westmead Hospital and The University of Sydney, Sydney, NSW, Australia.
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Abstract

Background

Hepatocellular carcinoma (HCC) represents an increasing global health challenge, associated with poor prognosis and an epidemiological shift towards an aging and comorbid population. Frailty is a multidimensional syndrome of reduced physiological reserve. It is recognized as a robust predictor of clinical outcomes in chronic liver disease and some cancers but remains underexplored in HCC.Summary

This narrative review synthesizes current evidence on the clinical significance of frailty in HCC, focusing on its impact on outcomes, evidence for targeted interventions, and potential role in clinical decision-making. Frailty is associated with adverse outcomes in HCC, including increased healthcare utilization, reduced treatment tolerance, and decreased survival. However, heterogeneity in frailty assessment methods and limited prospective data preclude its clinical application. Early evidence suggests that structured exercise programs are safe, feasible, and may improve frailty measures, although larger prospective studies are required to determine whether these translate into meaningful clinical benefits.Key messages

Frailty is an emerging prognostic marker and may inform supportive care in HCC. Standardized assessment and interventional trials are needed to support routine integration of frailty for more personalized HCC management.

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Cite

BibTeXRIS
BibTeX
@article{jacob2026impact,
  title = {{The Impact of Frailty in Hepatocellular Carcinoma.}},
  author = {Rachael Jacob and Shirin Salimi and Dinuli Kamaladasa and Karen Waller and Emily He and Mark Danta and Simone I Strasser and Geoff W McCaughan and Jacob George and Ken Liu},
  journal = {Liver cancer},
  year = {2026},
  month = aug,
  doi = {10.1159/lic/admag006},
  url = {https://europepmc.org/article/MED/42909954},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - The Impact of Frailty in Hepatocellular Carcinoma.
AU  - Rachael Jacob
AU  - Shirin Salimi
AU  - Dinuli Kamaladasa
AU  - Karen Waller
AU  - Emily He
AU  - Mark Danta
AU  - Simone I Strasser
AU  - Geoff W McCaughan
AU  - Jacob George
AU  - Ken Liu
PY  - 2026
DA  - 2026/08/24
JO  - Liver cancer
DO  - 10.1159/lic/admag006
UR  - https://europepmc.org/article/MED/42909954
AB  - Background  Hepatocellular carcinoma (HCC) represents an increasing global health challenge, associated with poor prognosis and an epidemiological shift towards an aging and comorbid population. Frailty is a multidimensional syndrome of reduced physiological reserve. It is recognized as a robust predictor of clinical outcomes in chronic liver disease and some cancers but remains underexplored in HCC.Summary  This narrative review synthesizes current evidence on the clinical significance of frailty in HCC, focusing on its impact on outcomes, evidence for targeted interventions, and potential role in clinical decision-making. Frailty is associated with adverse outcomes in HCC, including increased healthcare utilization, reduced treatment tolerance, and decreased survival. However, heterogeneity in frailty assessment methods and limited prospective data preclude its clinical application. Early evidence suggests that structured exercise programs are safe, feasible, and may improve frailty measures, although larger prospective studies are required to determine whether these translate into meaningful clinical benefits.Key messages  Frailty is an emerging prognostic marker and may inform supportive care in HCC. Standardized assessment and interventional trials are needed to support routine integration of frailty for more personalized HCC management.
SN  - 2235-1795
SN  - 1664-5553
ER  -