Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, Hubei, China.
Clin Interv Aging. 2023 Nov 14;18:1883-1892. doi: 10.2147/CIA.S429259. eCollection 2023.
Population aging has emerged as a pressing global concern and a significant medical challenge. The use of transarterial chemoembolization (TACE) has been extensively employed for managing unresectable hepatocellular carcinoma (HCC). However, there is limited evidence regarding the safety and effectiveness of TACE specifically in individuals aged 80 years and above.
To examine the safety and effectiveness of TACE in elderly patients (≥ 80 years) compared to younger patients (< 80 years) with HCC, and the potential risk factors that may impact the progression-free survival (PFS) for TACE were also identified.
A retrospective analysis was conducted on a consecutive cohort of unresectable HCC patients who were initially treated with TACE. The patients were categorized into two groups based on the age at which they underwent TACE, and the efficacy and safety of the treatment were evaluated. The PFS was investigated, and the prognostic factors were analyzed using the Kaplan-Meier method and Cox proportional hazard models.
A total of 198 patients were included in this study, with 44 patients aged 80 years or older and 154 patients younger than 80 years. The cumulative risk of PFS after TACE was similar between the two groups ( = 0.800). In the multivariate analysis, a lower ECOG score ( = 0.039) and an earlier BCLC stage ( = 0.004) were identified as independent predictors of better PFS. Patients in both groups tolerated the TACE treatment well.
The impact of aging on poor PFS is not significant. In patients with HCC, TACE therapy is both safe and effective for octogenarians, similar to younger patients. Furthermore, the better PFS is associated with a low ECOG score and an early BCLC stage.
人口老龄化已成为全球关注的紧迫问题和重大医学挑战。经导管肝动脉化疗栓塞术（TACE）已广泛用于治疗不可切除的肝细胞癌（HCC）。然而，关于 TACE 在 80 岁及以上人群中的安全性和有效性的证据有限。
研究 TACE 在年龄≥80 岁的老年 HCC 患者与年龄<80 岁的年轻 HCC 患者中的安全性和有效性，并确定可能影响 TACE 无进展生存期（PFS）的潜在危险因素。
对接受 TACE 初始治疗的不可切除 HCC 患者连续队列进行回顾性分析。根据接受 TACE 的年龄将患者分为两组，并评估治疗的疗效和安全性。研究 PFS，并使用 Kaplan-Meier 方法和 Cox 比例风险模型分析预后因素。
本研究共纳入 198 例患者，其中 44 例年龄≥80 岁，154 例年龄<80 岁。两组患者 TACE 后 PFS 的累积风险相似（=0.800）。多因素分析显示，ECOG 评分较低（=0.039）和 BCLC 分期较早（=0.004）是 PFS 较好的独立预测因素。两组患者均能耐受 TACE 治疗。
年龄对较差 PFS 的影响不显著。对于 HCC 患者，TACE 治疗对 80 岁以上患者和年轻患者同样安全有效。此外，更好的 PFS 与较低的 ECOG 评分和较早的 BCLC 分期相关。
