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Efficacy and long‐term outcomes of radiofrequency ablation in the elderly with hepatocellular carcinoma
Author(s) -
Yamazaki Hajime,
Tsuji Kunihiko,
Nagai Kazumasa,
Tomonari Akiko,
Matsui Takeshi,
Kang JongHon,
Kodama Yoshihisa,
Sakurai Yasuo,
Maguchi Hiroyuki
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12233
Subject(s) - medicine , hepatocellular carcinoma , radiofrequency ablation , stage (stratigraphy) , multivariate analysis , gastroenterology , surgery , ablation , paleontology , biology
Aim The use of radiofrequency ablation ( RFA ) in elderly patients is increasing in those with hepatocellular carcinoma ( HCC ). This study compares the elderly (≥75 years old) to non‐elderly patients (<75 years old) in the outcomes of the efficacy and safety of RFA . Methods Three hundred and thirty‐five patients, 103 elderly and 232 non‐elderly, with naive HCC who were treated with RFA from 1999 to 2012 were enrolled. Patient characteristics, complications, length of hospital stay, overall survival ( OS ), median survival time ( MST ), recurrence‐free survival ( RFS ) and factors related to OS were analyzed. Results Median age was 79 years (range, 75–88) in the elderly group and 65 years (38–74) in the non‐elderly group. The proportion of women (45.6% and 28.0%), hepatitis C virus infection (63.1% and 50.4%) and comorbidities (78.6% and 44.0%) in the elderly group compared to the non‐elderly group, respectively, was significantly higher. No difference existed in the complications and length of hospital stay. The 5‐year OS rates and MST were 67.3% and 90.5 months in the elderly group and 60.9% and 86.4 months in the non‐elderly group, respectively ( P = 0.486). The median RFS time was 20 months in the elderly group and 18.7 months in the non‐elderly group ( P = 0.429). In multivariate analysis, the C hild– P ugh grade and tumor–node–metastasis stage were significantly associated with OS ( P < 0.001, =0.003); age was not ( P = 0.355). Conclusion RFA in elderly patients is as effective and safe as in non‐elderly patients for the treatment of HCC .