Overall survival was inferior in octogenarians with early-stage hepatocellular carcinoma undergoing percutaneous radiofrequency ablation.
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BACKGROUND: It is unclear whether overall survival (OS) differs by age for patients with early-stage hepatocellular carcinoma (HCC) undergoing percutaneous radiofrequency ablation (pRFA). We aim to clarify this issue. MATERIALS AND METHODS: All patients diagnosed with early-stage HCC (i.e., within Milan criteria) and Child-Pugh class A liver disease undergoing pRFA between 2011 and 2021 were enrolled. Patients with incomplete ablation were excluded. This study enrolled 791 patients and them divided into four groups by age: <70 years (Group 1, n = 508), 70-74 years (Group 2, n = 122), 75-79 years (Group 3, n = 102), and ≥80 years (Group 4, n = 59). Survival analysis was performed using the Kaplan-Meier method with the log-rank test. Cox proportional hazards analysis was used to identify prognostic factors associated with OS. RESULTS: The five-year OS was 65 % in Group 1, 60 % in Group 2, 53 % in Group 3, and 38 % in Group 4 (p = 0.009). With Group 4 as the reference, multivariate analysis indicated that Groups 1 (hazard ratio [HR]: 0.496, 95 % confidence interval [CI]: 0.314-0.785, p = 0.003) and 3 (HR: 0.496, 95 % CI: 0.277-0.889, p = 0.018) but not Group 2 (HR: 0.689, 95 % CI: 0.403-1.179, p = 0.174) were independent factors associated with superior five-year OS. CONCLUSIONS: Among patients with early-stage HCC and Child-Pugh class A liver disease undergoing pRFA, those aged ≥80 years had inferior five-year OS.