The clinical role of radiofrequency ablation for early-stage hepatocellular carcinoma in an advanced aging society.

AIM: It 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.

METHODS: This 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.

RESULTS: The 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 non-liver-related disease (69.4%). In all groups, mALBI grade was a factor contributing to prolonged prognosis, but only in group4 performance status (PS) was a significant factor (HR: 2.46, 95% CI: 1.16-3.00, p=0.009).

CONCLUSION: For early-stage HCC in the elderly, preoperative evaluation of PS and management of other diseases may contribute to a prolonged prognosis. This article is protected by copyright. All rights reserved.