Radiofrequency Ablation For Hepatocellular Carcinoma In Elderly

Background: Surgical resection is traditionally suggested for treating early stage of hepatocellular carcinoma (HCC). However, resection is frequently unsuitable for elderly patients because of comorbidities. Radiofrequency ablation (RFA) has been shown to be as effective to treat small HCCs. This study aimed to investigate the effectiveness and outcomes of RFA for HCC in elderly.Methods: A total of 134 patients with 266 RFA sessions from 2008 to 2017 were retrospectively reviewed. Patients were divided into younger adult group (N = 56) and elderly group (N = 78) with a cut-off of 65 years of age. The elderly group was further divided into younger and older elderly by 75 years of age. Statistical analyses were performed, and a Kaplan-Meier method was applied for analyzing overall and recurrence-free survival.Results: Primary technique effectiveness was observed in 90.1% in younger adult group and 91.5% in elderly group. After a median follow-up of 32.0 months in younger adult and 38.6 months in elderly group, one-, three-, and five-year survival rates in younger adult group were 90.6%, 68.4%, and 56.1%, and in elderly group, 94.6%, 80.0%, and 61.7%, respectively. The recurrence-free survivals were similar between both groups. Older elderly group had inferior recurrence-free survival than younger elderly but the survival rates of all-cause or liver-related mortalities were similar in these two groups.Conclusion: RFA is a well-tolerated local ablative therapy across different ages. RFA for HCC in elderly has comparable rates of complete tumor ablation, recurrence-free survival, overall survival with that of younger adults. Copyright (C) 2020, Taiwan Society of Geriatric Emergency & Critical Care Medicine.