Safety and Prognosis of Transarterial Chemoembolization for Octogenarians with Hepatocellular Carcinoma

Abstract

Purpose: The global population of the aged is escalating. The need of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in patients older than 80 years is on the rise. The aim of this study was to retrospectively evaluate the safety and the prognosis of TACE in octogenarians with HCC. Materials and Methods: From January 2007 to January 2018, 86 octogenarians with HCC initially treated with TACE, who were treatment naïve or had a recurrence after surgery and/or radiofrequency ablation, were enrolled in this study. The adverse events were evaluated. The overall survival (OS) after TACE and causes of death were investigated. The prognostic factors for OS were analyzed using Cox proportional hazard models. Results: Grade 4 adverse events (according to the Common Terminology Criteria for Adverse Event version 4.0) of AST, ALT and tumor rupture were found in 8, 4 and 1 patients, respectively. There were no treatment-related deaths. The 1-, 3- and 5-year overall survival rates were 84.1%, 61.1% and 27.6%, respectively. The overall median survival time was 38.3 months (HR 2.854, 95% CI 32.7–43.8). 56.9% causes of death were HCC or liver dysfunction. Multivariate analysis revealed that performance status (ECOG: 0) was an independent prognostic significant factor (95% CI 1.103–4.573; P =.026). Conclusions: TACE is safe and could improve survival of octogenarians with HCC. Performance status is an important prognosis factor predicting the OS.