**3. Surgical therapy**

Geriatric patients may be extremely complex to treat due to comorbidities that may affect them. Therefore, a clinical evaluation is fundamental to assess the best treatment for each patient.

Aspects that must be considered comprehend not only biological age, HCC stage, and liver status, but also general patient conditions, performance status, and, in particular, individual and familial psychological frame, will to fight against the disease, and treatment tolerability. All these parameters are included into the concept of physiological age which goes far beyond chronological age and considers many crucial aspects of aging which is an extremely

Since chronologic age alone is a poor descriptor of heterogeneity in the aging process, a systematic and evidence-based way to assess physiological age is needed to guide treatment

Comprehensive geriatric assessment (CGA) is defined as a multidimensional, interdisciplinary diagnostic process focusing on determining an older person's medical, psychosocial, and functional capabilities to develop a coordinated and integrated plan for treatment and long-

Important reasons to perform GA in older patients with cancer are detection of unidentified problems and risks for which targeted interventions can be applied and prediction of adverse outcomes (e.g., toxicity, other relevant items such as functional or cognitive decline, postoperative complications); and better estimation of residual life expectancy and lethality of the malignancy in the context of competing comorbidities and general health problems. There is

individual process.

term follow-up [10] (**Table 1**).

**Table 1.** Considered parameters in Comprehensive geriatric Assessment.

decisions.

36 Liver Cancer
