Abstract:
BACKGROUND:The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is progressively increasing. The aim of this study was to determine the safety and efficacy of conventional transarterial chemoembolization (TACE) in elderly HCC patients compared with younger adults. METHODS:A consecutive cohort of unresectable HCC patients treated with TACE as a first-line treatment was retrospectively analyzed. Patients were categorized into "elderly" (≥ 70 years, 80 patients) and "younger" (< 70 years, 145 patients). Liver-related death and progression-free survival after TACE were compared before and after propensity score matching. A competing risk regression analysis was used for univariate/multivariate survival data analysis. RESULTS:cTACE was well tolerated in both groups. The cumulative risk of both liver-related death and progression-free survival after cTACE was comparable between "elderly" and "younger" (death: 73.8% vs 69.4%, P = 0.505; progression-free survival: 48.2% vs 44.8%, P = 0.0668). Propensity model matched 61 patients in each group for gender and Barcelona Clinic Liver Cancer staging. Even after matching, the cumulative risk of liver-related death and of progression-free survival did not differ between the two groups. At multivariate analysis, Child-Pugh class, tumor gross pathology and alpha-fetoprotein were independently associated with the liver-related mortality risk. CONCLUSIONS:This study confirms that TACE is well tolerated and effective in patients aged 70 years or more with unresectable HCC as it is for their younger counterparts (< 70 years). Liver-related mortality was not associated with age ≥ 70 years and primarily predicted by tumor multifocality, Child-Pugh class B and an increased alpha-fetoprotein value (> 31 ng/ml).
journal_name
Cardiovasc Intervent Radioljournal_title
Cardiovascular and interventional radiologyauthors
Mosconi C,Gramenzi A,Biselli M,Cappelli A,Bruno A,De Benedittis C,Cucchetti A,Modestino F,Peta G,Bianchi G,Trevisani F,Golfieri Rdoi
10.1007/s00270-020-02451-3subject
Has Abstractpub_date
2020-07-01 00:00:00pages
1015-1024issue
7eissn
0174-1551issn
1432-086Xpii
10.1007/s00270-020-02451-3journal_volume
43pub_type
杂志文章abstract::In the last years, the interest into interventional applications of C-arm cone-beam CT (CBCT) progressively raised, widening its clinical application from the original field of interventional neuroradiology to the field of peripheral procedures. Liver embolization procedures, due to their complexity and potential trea...
journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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