title: Efficacy and tolerability of laparoscopic-assisted radiofrequency ablation of hepatocellular carcinoma in patients above 60 years of age.
abstract: The purpose of this study was to evaluate the safety and efficacy of laparoscopic-assisted radiofrequency ablation (RFA) in patients with hepatocellular carcinoma above the age of 60 years. A single-center, retrospective study of a prospective dataset evaluated efficacy and morbidity of RFA in patients above 60 years of age. About 37% of patients had an intrahepatic recurrence 1 year after ablation. By multivariate analysis, only the number of lesions ablated was a predictor of recurrence (P=0.007). Overall mortality was 19% at 1 year and factors associated with mortality include elevated α-fetoprotein, number of lesions ablated, and platelet count. Complications occurred in 10% of our population with 1 death. RFA is well tolerated in patients of 60 years of age and above. The outcomes in this study validate a local ablative strategy for the treatment of hepatocellular carcinoma in the elderly and it is superior to no treatment alone.
authors.affiliation: Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Leora J
authors.initials: LJ
authors.lastname: Tesche
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Newton
authors.forename: Joshua
authors.initials: J
authors.lastname: Unger
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
authors.forename: David A
authors.initials: DA
authors.lastname: Gerber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis