The outcomes of elderly patients with hepatocellular carcinoma treated with transarterial chemoembolization.
BACKGROUND
The authors evaluated and compared the treatment outcomes of transarterial chemoembolization (TACE) between young (<or=70 years) and elderly (>70 years) patients at their institute over an 18-year period.


METHODS
Advanced hepatocellular carcinoma (HCC) patients who received TACE at the authors' center were analyzed retrospectively. The demographic data, TACE-related morbidities, and survival outcome were compared between these 2 age groups.


RESULTS
Between 1989 and 2006, 843 patients who were <or=70 years old and 197 patients who were >70 years old received TACE treatment for advanced HCC. There were significantly more comorbid illnesses associated with the elderly patients than the young patients (64 % vs 33%, P < .01). Moreover, elderly patients who received TACE treatment for HCC were at earlier stages of disease (P < .01). Both the overall median survival (14.0 months vs 8.1 months, P < .003) and disease-specific survival (15.2 months vs 8.7 months, P < .001) were significantly higher in elderly than young patients. The most commonly encountered TACE-related morbidity in both age groups was liver function derangement. Young patients had a significantly higher rate of developing liver derangement after TACE than elderly patients (21% vs 11%, P < .01). Conversely, the elderly patients had a significantly higher rate of developing peptic ulcer disease with TACE treatment than young patients (2.5% vs 0.5%, P = .01). Overall, there was no significant difference in TACE-related mortality between the young and elderly patients (3% vs 4%, P = .49).


CONCLUSIONS
This study has confirmed the comparable efficacy and tolerability in using TACE for the treatment of advanced HCC in young and elderly patient populations.
Yau
Thomas
T
Department of Medicine, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.
Yao
Tzy Jyun
TJ
Chan
Pierre
P
Epstein
Richard John
RJ
Ng
Kelvin K
KK
Chok
Siu Ho
SH
Cheung
Tan Teo
TT
Fan
Sheung Tat
ST
Poon
Ronnie Tung Ping
RT
D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D055815:Young Adult