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In order to determine the clinical features of hepatocellular carcinoma in the elderly, a total of 622 patients with hepatocellular carcinoma, including 91 patients 70 years or older, were retrospectively analysed with reference to their ages at the time of diagnosis. The proportion of females increased and that of hepatitis B surface antigen-positive cases decreased as age increased. Tumour sizes at the time of diagnosis were somewhat smaller in the elderly than in younger patients, whereas clinical stage taking liver function into consideration was similar in the two age groups. The prognosis in the elderly patients was similar to that in the younger ones in a clinical stage-matched comparison. Furthermore, by a multivariate analysis using the Cox proportional hazards model with inclusion of age and other clinical parameters, age was not selected in the final model as an independent predictor for survival. These results indicate that elderly patients with hepatocellular carcinoma have certain clinical features different from those in younger patients and that their prognosis is not necessarily poorer than in the latter.