ArticleScientific reports2025
Impact of frailty on the long-term prognosis of the elderly with hepatocellular carcinoma treated with transarterial chemoembolization.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Frailty in hepatobiliary and pancreatic (HBP) surgery: a narrative review toward an HBP-specific, implementation-oriented framework.Gland surgery · 2026Review
- Frailty in Hepatocellular Carcinoma: An Unsettled Clinical Challenge.Current oncology (Toronto, Ont.) · 2026Review
- Impact of Preoperative Frailty on Postoperative Complications and Cognitive Impairment in Liver Cancer Patients: An Observational Cohort Study.Clinical interventions in aging · 2026Observational
- Influencing factors affecting health-promoting lifestyles in patients with primary liver cancer: a latent profile analysis.Scientific reports · 2025Article
- Volatile organic compounds exposure associated with frailty in United States adults from NHANES 2011-2018.Frontiers in public health · 2025Article
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5 authors.
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Abstract
Transcatheter arterial chemoembolization (TACE) is a standard treatment for unresectable, intermediate, or advanced-stage hepatocellular carcinoma (HCC), especially in elderly patients. The modified 5-item frailty index (mFI-5) is a concise, comorbidity-based risk stratification tool proven to effectively predict adverse outcomes. However, the prognostic capacity of the mFI-5 in elderly HCC patients after TACE is unclear. As such, we retrospectively analyzed clinical data from elderly HCC patients (age ≥ 65 years) who received their first TACE between November 2018 and November 2020 at the Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University. The mFI-5 was calculated based on the presence of five co-morbidities: congestive heart failure within 30 days prior to surgery; insulin-dependent or noninsulin-dependent diabetes mellitus; chronic obstructive pulmonary disease (COPD) or pneumonia; partially dependent or totally dependent functional health status at time of surgery; and hypertension requiring medication. Patients were divided into two groups based on mFI-5 scores: mFI-5 ≥ 2 ('frail') and mFI-5 < 2 ('non-frail'). The primary outcomes were overall survival (OS) and progression-free survival (PFS).Among the 143 patients, 97 were in the mFI-5 < 2 group and 46 in the mFI-5 ≥ 2 group. The median OS was 40.0 months (95% confidence interval [CI]: 35.0-47.0) in the non-frail group vs. 24.0 months (95% CI: 22-NA) in the frail group (hazard ratio [HR] = 3.343, 95% CI: 1.802-6.201, p < .001). The median PFS was 7.0 months (95% CI: 4.0-11.0) vs. 3.0 months (95% CI: 2.0-9.0) (HR = 1.507, 95% CI: 0.996-2.280, p = .053). Cox regression identified mFI-5, alpha-fetoprotein (AFP) as independent predictors of OS. The mFI-5 is a useful predictor of long-term survival in elderly HCC patients treated with TACE, suggesting that incorporating frailty assessments can optimize treatment strategies and improve outcomes.
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