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Master Thesis

Tolérance de la chimio-embolisation pour le traitement du carcinome hépatocellulaire chez les patients âgés

Abstract : Introduction: Transarterial chemo-embolization is the most widely used treatment for hepatocellular carcinoma (HCC) in the world. Its efficacy has been demonstrated by several studies. However, safety data are limited, especially in the elderly. The aim of our study is to describe the safety profile of chemo-embolization for hepatocellular carcinoma in patients aged 70 years or more compared to younger patients. Materials and Methods: In this retrospective study, patients who received a first transarterial chemo-embolization for hepatocellular carcinoma at Grenoble University Hospital from January 2012 to March 2017 were included. They are divided into two groups according to age greater or below 70 years. The rates of early (during initial hospitalization), late (between discharge from hospital and oncological reassessment) and overall complications are assessed in each group and compared. Predictive factors of severe adverse events are studied using univariate and multivariate analyzes. Results: 271 patients were included in our study: 88 aged 70 or more and 183 in the younger group. The rate of severe adverse events in elderly patients is 20.5% compared to 21.3% in younger patients. There is no significant difference between the two groups (p = 0.87). The predictive factors of severe adverse events are a Child-Pugh score ≥ B7 (p < 0.0001), a PS ≥ 1 (p = 0.0019) and a MELD score ≥ 9 (p = 0.0415). Multifocal HCC and the use of idarubicin as chemotherapy are associated with reduced occurrence of severe adverse events (p = 0.0396 and p = 0.0351, respectively). Age 70 years or older is not associated with the occurrence of severe adverse events (p = 0.87). Conclusion: Our results show that safety profile of transarterial chemo-embolization for hepatocellular carcinoma in elderly is comparable to that of younger patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02950811
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Submitted on : Monday, September 28, 2020 - 12:07:16 PM
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Olivier Hernandez. Tolérance de la chimio-embolisation pour le traitement du carcinome hépatocellulaire chez les patients âgés. Médecine humaine et pathologie. 2020. ⟨dumas-02950811⟩

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