The impact of age on the survival outcomes of hepatocellular carcinoma patients after transarterial chemoembolization: A systematic review and meta-analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background & Objective: The efficacy of transarterial chemoembolization (TACE) in different populations of hepatocellular carcinoma (HCC) patients is still unclear. This meta-analysis explores the impact of TACE on survival outcomes in elderly versus younger patients with HCC, considering regional variations and heterogeneity among studies. Methods: Nineteen studies involving 30,093 participants were systematically reviewed from January 1964 to January 2024. Data were pooled using random-effects models to calculate hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CI) for overall survival and survival rates, respectively. Subgroup analyses were conducted based on age cut-offs and geographical regions to assess the effect of these variables on treatment outcomes. Results: Pooled HR for overall survival did not show a significant difference between elderly and younger patients (HR = 1.00; 95% CI: 0.98 to 1.02), with similar findings for survival rates (OR = 0.82; 95% CI: 0.46 to 1.45). Substantial heterogeneity was observed (I² = 78.0% for HR and 94.3% for OR), with notable regional differences indicating lower survival odds in European studies compared to Asian ones. No significant effect (OR = 0.95) was detected in prospective studies, while retrospective studies indicated a significant reduction in survival rates in elderly patients (OR = 0.35). Conclusion: TACE appears to be equally effective in elderly and younger HCC patients. However, significant regional differences and study heterogeneity suggest the need for personalized treatment approaches. Further research is required to understand the underlying causes of these variations and to optimize TACE protocols. doi: https://doi.org/10.12669/pjms.41.4.11718 How to cite this: Du X, Zhang X. The impact of age on the survival outcomes of hepatocellular carcinoma patients after transarterial chemoembolization: A systematic review and meta-analysis. Pak J Med Sci. 2025;41(4):1234-1243. doi: https://doi.org/10.12669/pjms.41.4.11718 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Authors: Xue Du, Xiaoting Zhang
Institution: Lishui Central Hospital
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $400
OpenAlex ID: W4408963191