Trans-arterial chemo-embolization is safe and effective for very elderly patients with hepatocellular carcinoma

Table 1 Patient characteristics n (%)

	< 65 yr (n = 38)	65-75 yr (n = 41)	≥75 yr (n = 23)	P value	HR (95%CI)
Age group multivariate HR (95%CI)1	1	1.03 (0.58-1.83)	1.04 (0.56-1.9)		-
Female	35 (92.2)	24 (58.6)	16 (69.6)	0.003	0.55 (0.31-0.98)1
Cirrhosis at diagnosis	35 (92.1)	41 (1)	22 (95.6)	0.338
Ascites at diagnosis	4 (10.5)	4 (9.7)	4 (17.3)	0.632
Hepatitis B virus	12 (31.5)	7 (17.0)	2 (8.6)	0.06	0.85 (0.49-1.47)1
Hepatitis C virus	21 (55.2)	29 (70.7)	18 (78.2)	0.14
Cancer of the Liver Italian Program2				0.008
0	8 (21.0)	20 (48.7)	7 (30.4)		1.9 (1.5-2.4)2
1	6 (15.7)	13 (31.7)	9 (39.1)
2	17 (44.7)	8 (19.5)	5 (21.7)
3	6 (15.7)	0 (0.0)	2 (8.6)
4	1 (2.6)	0 (0.0)	0 (0.0)
Okuda2				0.001
1	21 (55.2)	39 (95.1)	19 (82.6)		5 (2.7-9.1)2
2	16 (42.1)	2 (4.8)	4 (17.3)
3	1 (2.6)	0 (0.0)	0 (0.0)
Child-Pugh-Turcot2				0.98
1	31 (81.5)	35 (85.3)	19 (82.6)		2.1 (1.2-3.6)2
2	6 (15.7)	5 (12.1)	3 (13.0)
3	1 (2.6)	1 (2.4)	1 (4.3)
Barcelona Clinic Liver Cancer				0.027
1	3 (7.8)	15 (36.5)	3 (13.0)		2.3 (1.65-3.2)2
2	7 (18.4)	6 (14.6)	5 (21.7)
3	26 (68.4)	19 (46.3)	15 (65.2)
Procedures				0.16
1	12 (31.5)	4 (9.7)	7 (30.4)
2	12 (31.5)	12 (29.2)	8 (34.7)
3	6 (15.7)	11 (26.8)	2 (8.6)
> 3	8 (20.9)	14 (31.4)	6 (26.0)
Number of procedures	2.4 ± 1.6	3.4 ± 2.0	2.7 ± 2	0.07
Albumin at diagnosis	36.37 ± 4.4	36.3 ± 4.7	36.0 ± 5.2	0.96	0.97 (0.84-1.11)1
Alpha-fetoprotein at diagnosis	944 ± 2162	337 ± 729	9232 ± 31376	0.05
International normalized ratio at diagnosis	1.14 ± 0.23	1.19 ± 0.25	1.12 ± 0.18	0.46	11
Bilirubin at diagnosis	2.9 ± 7.8	1.02 ± 0.66	1.17 ± 0.56	0.19

¹Hazard ratio (HR) (95%CI) when controlling for Barcelona Clinic Liver Cancer (BCLC) in multivariate model;

²Multivariate HRs used instead of BCLC.

Table 2 Trans-arterial chemo-embolization procedure characteristics n (%)

	< 65 yr	65-75 yr	≥75 yr	P value
Number of procedures	93	129	61
Preparation for contrast material exposure	18 (19)	38 (29)	14 (22)	0.37
Iodine allergy and preparation	1 (1)	21 (16)	0 (0)	< 0.001
Antibiotic prophylaxis	68 (73)	95 (73)	44 (72)	0.7
Cefamezine	63 (67)	87 (67)	44 (71)
Ceftazidime	1 (1)	1 (0.7)	0 (0)
Clindamycin	2 (2)	1 (0.7)	0 (0)
Clindamycin and Ciprofloxacin	0 (0)	1 (0.7)	0 (0)
Vancomycin	2 (2)	1 (0.7)	0 (0)
Right upper quadrant abdominal pain	16 (17)	24 (18)	5 (8)	0.22
Nausea	9 (9.6)	17 (13.1)	1 (1.6)	0.057
Fatigue	6 (6)	6 (4)	1 (1)	0.36
Fever	21 (22)	26 (2)	5 (8)	0.07
Post-embolization syndrome	23 (24)	36 (27)	10 (16)	0.3
Readmission	3 (3.2)	8 (6.2)	1 (1.6)	0.34
Total length of stay	3.6 (1.14)	3.55 (1.1)	3.3 (0.9)	0.19