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

Authors: Thornton, R. H.; Covey, A.; Petre, E. N.; Riedel, E. R.; Maluccio, M. A.; Sofocleous, C. T.; Brody, L. A.; Getrajdman, G. I.; D'Angelica, M.; Fong, Y.; Brown, K. T.
Article Title: 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.
Keywords: adult; controlled study; treatment outcome; aged; aged, 80 and over; survival rate; major clinical study; overall survival; clinical trial; mortality; hepatocellular carcinoma; artificial embolism; chemoembolization; hepatitis b; hepatitis c; liver cell carcinoma; carcinoma, hepatocellular; liver neoplasms; comparative study; prospective study; demography; infection; kidney disease; incidence; morbidity; kidney failure; practice guideline; age; hypoxia; liver failure; intensive care unit; length of stay; hospitalization; disease severity; cardiovascular disease; heart infarction; comorbidity; colitis; aging; bacteremia; cardiopulmonary insufficiency; heart arrhythmia; liver abscess; hematoma; hepatic artery embolization; urine retention; hepatobiliary disease; heart atrium fibrillation; cholecystitis; congestive heart failure; embolization, therapeutic; tachycardia; vascular disease; artery injury; transcatheter arterial embolization; cardiopulmonary arrest; groin hematoma
Journal Title: Cancer
Volume: 115
Issue: 21
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2009-11-01
Start Page: 5000
End Page: 5006
Language: English
DOI: 10.1002/cncr.24556
PUBMED: 19642175
PROVIDER: scopus
Notes: --- - "Export Date: 30 November 2010" - "CODEN: CANCA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Anne Covey
    118 Covey
  2. Yuman Fong
    741 Fong
  3. Lynn Brody
    93 Brody
  4. Karen T Brown
    161 Brown
  5. Elena Nadia Petre
    48 Petre