HCC outcome at the age of 80 and beyond with RF Ablation
The study conducted at Musashino Red Cross Hospital in Tokyo evaluated the effectiveness and safety of radiofrequency ablation (RFA) for treating hepatocellular carcinoma (HCC) in patients aged 80 years and older. The analysis included 518 patients, of which 136 were elderly (≥80 years) and 382 were younger (<80 years). All patients had tumors ≤3 cm and ≤3 nodules within the Milan criteria.
Key findings for elderly patients (≥80 years) include:
Overall Survival (OS): Median OS for elderly patients was 80 months, significantly shorter than the 123 months observed in younger patients (p=0.021). However, age itself did not significantly affect liver disease-related mortality.
Recurrence-Free Survival (RFS): Median RFS was shorter for elderly patients (17 months) compared to younger patients (27 months), with a statistically significant difference (p=0.017). Elderly age was identified as a risk factor for recurrence.
Prognostic Factors: Poor survival and recurrence were associated with higher ALBI grade, elevated DCP levels (≥40 mAU/mL), persistent HCV infection, and nonviral liver disease.
Safety and Complications: RFA demonstrated acceptable safety with only 3.9% of patients experiencing complications (e.g., bleeding, pneumothorax, renal dysfunction), and no treatment-related deaths were reported.
Clinical Implication: Despite slightly shorter survival, RFA remains a viable, safe, and effective treatment for elderly HCC patients. Age ≥80 years did not significantly impact liver disease-specific mortality, indicating effective post-recurrence management.
