Safety of transcatheter arterial chemoembolization for hepatocellular carcinoma in older adults aged ≥ 85 years: A single-institution retrospective preliminary study

Abstract

This study aims to evaluate the safety of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in elderly patients (aged ≥ 85 years). This study examined 20 consecutive TACE procedures performed in 20 treatment-naïve patients aged ≥ 85 years for HCC between May 2010 and February 2023. Patient and TACE procedure data were retrospectively obtained. The patients were followed up during their hospital stay for the clinical symptoms of postembolization syndrome (PES), including fever, pain, nausea, and vomiting. In addition, their length of hospital stay, TACE-related complications, objective response rate (ORR), time to TACE progression (TTTP), and overall survival (OS) were reviewed. In five, two, 10, and three procedures, TACE was performed using powdered cisplatin without lipiodol, epirubicin–lipiodol emulsion, miriplatin–lipiodol suspension, and drug-eluting beads, respectively. The main baseline characteristics of the patients and TACE procedures were as follows: age, 86.0 (interquartile range [IQR], 85.0–86.0) years; sex, male/female (14/6); Child–Pugh classification, A/B (19/1); and maximum tumor size, 5.0 (IQR, 3.9–6.6 cm). The incidence of PES was 55% (11/20). No severe PES was observed. Furthermore, procedure-related complications did not occur, and the TACE-related mortality rate was 0%. The median length of hospital stay was 6 days, and the ORR was 70% (14/20). The median TTTP and survival time were 3.3 (IQR, 2.3–5.5) months and 22.1 (IQR, 11.0–37.1) months, respectively. The OS rates at 1, 3, and 5 years were 70% (14/20), 25% (5/20), and 5% (1/20), respectively. In conclusion, TACE for HCC in elderly patients aged ≥ 85 years has the possibility of being safe and acceptable.