Journal
FRONTIERS IN ONCOLOGY
Volume 9, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2019.00113
Keywords
hepatic resection; radiofrequency ablation; elderly; tumor size; real-world study
Categories
Funding
- National Natural Science Foundation of China [81470870, 81670601, 81570593, 81702393]
- Guangdong Natural Science Foundation [2016A030313278, 2015A030313038, 2015A030312013, 2017A030310373]
- Science and Technology Program of Guangzhou city [2014Y2-00544, 2014Y2-00200, 201604020001, 201508020262, 201400000001-3, 201607010024]
- Science and Technology Program of Guangdong Province [2017B020209004, 20169013]
- National 13th Five-Year Science and Technology Plan Major Projects of China [2017ZX10203205-006-001]
- Guangdong Key Laboratory of Liver Disease Research [2017B030314027]
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Background: Because of the poor health conditions of elderly patients (age >65) with very-early-stage and early-stage hepatocellular carcinoma (HCC), primary treatment via hepatic resection (HR), or radiofrequency ablation (RFA) must be considered. However, few studies have examined this issue. Methods: A retrospective cohort was obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. Patients were grouped by tumor size (0-20, 21-30, 31-35, and 31-50mm) and age (>65 and <= 65). Overall survival (OS) and disease-specific survival (DSS) were assessed. Results: In total, 1912 patients aged >65 and 2,784 patients aged <= 65 were analyzed after propensity score matching (PSM). For patients >65 with tumors <= 20mm, OS and DSS did not differ significantly between the RFA and HR groups (p = 0.47 and p = 0.76, respectively). For patients with tumors measuring 21-30mm, the HR group had better OS and a trend toward better DSS compared with the RFA group (p = 0.03 and p = 0.09, respectively). For patients with tumors measuring 31-50mm, the HR group had better OS and DSS compared with the RFA group (p < 0.001 for both). For patients <65, the HR group had better OS and DSS compared with the RFA group for all tumor sizes. Conclusions: For elderly patients (age >65), RFA is recommended for tumors <= 20mm. For patients older than 65 with tumors measuring 21-50mm and for those younger than 65 with tumors of any size, HR is the better choice.
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