Clinical role of radiofrequency ablation for early-stage hepatocellular carcinoma in an advanced aging society

AimIt is unclear whether prognosis differs by age for early-stage hepatocellular carcinoma (HCC). We aimed to examine prognosis and recurrence after radiofrequency ablation (RFA) for early-stage HCC and to determine its prognostic factors for different age groups. MethodsThis retrospective study enrolled 1079 patients with initial early-stage HCC treated with RFA at two institutions. All patients in this study were divided into four groups: <70 years old (group1, n = 483), 70-74 years old (group2, n = 198), 75-79 years old (group3, n = 201), and >= 80 years old (group4, n = 197). Prognostic factors were evaluated by comparing survival and recurrence rates between each group. ResultsThe median survival time and 5-year survival rates for each group were 113 months and 70.8% in group1, 99.2 months and 71.5% in group2, 91.3 months and 66.5% in group3, and 71 months and 52.6% in group 4, respectively. Group4 had a significantly shorter survival than the other groups (p < 0.05). There were no significant differences in recurrence-free survival among the groups. In group4, the most common cause of death was nonliver-related disease (69.4%). In all groups, modified albumin-bilirubin index grade was a factor contributing to prolonged prognosis, but only in group4 performance status (PS) was a significant factor (hazard ratio, 2.46; 95% confidence interval, 1.16-3.00; p = 0.009). ConclusionFor early-stage HCC in the elderly, preoperative evaluation of PS and management of other diseases could contribute to a prolonged prognosis.

Automated summary

This study aims to investigate the prognosis and recurrence after radiofrequency ablation (RFA) for early-stage hepatocellular carcinoma (HCC) in different age groups. The results showed that patients aged 80 years and older had worse prognosis, but there were no significant differences in recurrence rates among the groups. For patients aged 80 years and older, in addition to the modified albumin-bilirubin index, performance status was also a significant factor affecting prognosis. Therefore, preoperative evaluation of performance status and management of other diseases could contribute to a prolonged prognosis in elderly patients with early-stage HCC.