Radiofrequency ablation therapy for hepatocellular carcinoma in elderly patients.
OBJECTIVE
With the aging of society, the number of elderly patients with hepatocellular carcinoma (HCC) has been increasing in Japan. The Government of Japan defines elderly as being over 65 and has divided the elderly into two stages: the first elderly stage (< 75 years old) and the second elderly stage (> or = 75). We investigated the efficacy and safety of radiofrequency ablation therapy (RFA) in patients in the second elderly stage in comparison with other HCC patients, retrospectively.


METHODS
Two hundred six patients with HCC, who were within the Milan criteria, with low-grade performance status (0 or 1) and a Child-Pugh classification of A or B were enrolled. All were treated with RFA from January 2000 to December 2008 as an initial therapy and were divided into elderly HCC group (e-HCC group; > or = 75, n = 63) and non e-HCC group (< 75, n = 143), and their clinical data and survival rates were compared.


RESULTS
Age and the level of protein induced by vitamin K absence or antagonist (PIVKA-II) were higher in the e-HCC group as compared with the non e-HCC group (78.3 +/- 3.2 vs 64.2 +/- 7.5 years, 676.3 +/- 2643.7 vs 142.4 +/- 442.2 mAU/mL: P < 0.01, respectively). There were no significant differences for Child-Pugh class, tumor node metastasis stage, and Japan Integrated Stage score and in survival rates after 3, and 5 years between the groups (e-HCC group: 82.5% and 49.7%, respectively; non e-HCC group: 78.3% and 57.5%, respectively). There were no severe complications in the e-HCC group.


CONCLUSIONS
Elderly HCC patients, who have good performance status, should be treated in the same manner and with the same strategy as young HCC patients.
Hiraoka
Atsushi
A
Department of Gastroenterology, Ehime University Graduate School of Medicine, Ehime, Japan. hirage@m.ehime-u.ac.jp
Michitaka
Kojiro
K
Horiike
Norio
N
Hidaka
Satoshi
S
Uehara
Takahide
T
Ichikawa
Soichi
S
Hasebe
Aki
A
Miyamoto
Yasunao
Y
Ninomiya
Tomoyuki
T
Sogabe
Ichiro
I
Ishimaru
Yoshihiro
Y
Kawasaki
Hideki
H
Koizumi
Yohei
Y
Hirooka
Masashi
M
Yamashita
Yoshimasa
Y
Abe
Masanori
M
Hiasa
Yoichi
Y
Matsuura
Bunzo
B
Onji
Morikazu
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D018579:Patient Selection; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin