A comparison of outcomes from treating hepatocellular carcinoma by hepatic artery embolization in patients younger or older than 70 years

Abstract

BACKGROUND: The objective of this study was to compare the morbidity, mortality, and survival of patients aged <70 years and aged ≥70 years who underwent hepatic arterial embolization (HAE) for the treatment of hepatocellular carcinoma (HCC). METHODS: Between 1997 and 2007, 386 patients underwent HAE for HCC at a single center. Two hundred patients were aged <70 years (153 men; median age, 60 years), and 186 patients were aged ≥70 years (128 men; median age, 75 years). Patients underwent a total 965 embolization procedures (median, 2 procedures per patient). Patient demographics, morbidity, mortality, length of hospital stay, and survival were analyzed. Complications were categorized using Common Terminology Criteria for Adverse Events, version 3.0 guidelines. Survival was calculated by using the Kaplan-Meier method. RESULTS: There were no significant differences between younger and older groups in the incidence of infectious, hepatobiliary, renal, vascular, or miscellaneous complications (P ≥ .05); complication severity (P = .82); procedural mortality (P = .63); length of hospitalization (P = .55); intensive care unit admission (P = .64); or overall survival (P = .30). There were more cardiopulmonary complications in the older group (P = .04), but the association of age and likelihood of a cardiopulmonary complication lost significance after adjusting for the presence of more cardiovascular comorbidities in the older group (P = .08). CONCLUSIONS: Survival and mortality outcomes of HAE for the treatment of HCC were similar whether patients were aged <70 years or ≥70 years. Although patients aged ≥70 years with cardiovascular comorbidities more often had a cardiopulmonary complication, other morbidity measures, including complication severity, need for intensive care unit admission, and length of hospitalization, were similar between groups. © 2009 American Cancer Society.