To analyze the risk factors for acute hepatic function deterioration after conventional transcatheter arterial chemoembolization (TACE) in elderly patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma.

A retrospective analysis was performed on the clinical data of 136 elderly patients with BCLC stage B hepatocellular carcinoma who underwent conventional TACE from January 2022 to January 2025. According to the occurrence of acute hepatic function deterioration after surgery, the patients were divided into the deterioration group (n=32) and the non-deterioration group (n=104). Their clinical data were analyzed, and univariate analysis and Logistic multivariate regression analysis were used to identify the risk factors for acute hepatic function deterioration after TACE. P<0.05 was considered statistically significant.

Univariate analysis showed that the deterioration group had a significantly higher proportion of Child-Pugh class B, higher rates of complicated liver cirrhosis and portal vein tumor thrombus, larger tumor invasion range (>50%), and higher preoperative levels of neutrophil-to-lymphocyte ratio (NLR), aspartate aminotransferase-to-platelet ratio index (APRI), and γ-glutamyl transpeptidase-to-platelet ratio index (GPRI) compared with the non-deterioration group (P<0.05). Logistic multivariate regression analysis revealed that Child-Pugh class B, complicated liver cirrhosis, portal vein tumor thrombus, tumor invasion range >50%, and high preoperative levels of NLR, APRI, and GPRI were independent risk factors for acute hepatic function deterioration after conventional TACE in elderly patients with BCLC stage B hepatocellular carcinoma. However, this study had limitations in sample size, especially the relatively small number of hepatic function deterioration events, and the above multivariate analysis results need to be validated in larger samples.

Acute hepatic function deterioration after conventional TACE in elderly patients with BCLC stage B hepatocellular carcinoma is influenced by factors such as Child-Pugh classification, liver cirrhosis, portal vein tumor thrombus, tumor invasion range, and preoperative levels of NLR, APRI, and GPRI.