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 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). Conclusion: For early‐stage HCC in the elderly, preoperative evaluation of PS and management of other diseases could contribute to a prolonged prognosis. [ABSTRACT FROM AUTHOR]