title: Efficacy and long-term outcomes of radiofrequency ablation in the elderly with hepatocellular carcinoma.
abstract: OBJECTIVE
  The use of radiofrequency ablation (RFA) in elderly patients is increasing in those with hepatocellular carcinoma (HCC). This study compares the elderly (≥75 years old) to non-elderly patients (<75 years old) in the outcomes of the efficacy and safety of RFA.
  
  
  METHODS
  Three hundred and thirty-five patients, 103 elderly and 232 non-elderly, with naive HCC who were treated with RFA from 1999 to 2012 were enrolled. Patient characteristics, complications, length of hospital stay, overall survival (OS), median survival time (MST), recurrence-free survival (RFS) and factors related to OS were analyzed.
  
  
  RESULTS
  Median age was 79 years (range, 75-88) in the elderly group and 65 years (38-74) in the non-elderly group. The proportion of women (45.6% and 28.0%), hepatitis C virus infection (63.1% and 50.4%) and comorbidities (78.6% and 44.0%) in the elderly group compared to the non-elderly group, respectively, was significantly higher. No difference existed in the complications and length of hospital stay. The 5-year OS rates and MST were 67.3% and 90.5 months in the elderly group and 60.9% and 86.4 months in the non-elderly group, respectively (P = 0.486). The median RFS time was 20 months in the elderly group and 18.7 months in the non-elderly group (P = 0.429). In multivariate analysis, the Child-Pugh grade and tumor-node-metastasis stage were significantly associated with OS (P < 0.001, =0.003); age was not (P = 0.355).
  
  
  CONCLUSIONS
  RFA in elderly patients is as effective and safe as in non-elderly patients for the treatment of HCC.
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tsuji
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nagai
authors.forename: Akiko
authors.initials: A
authors.lastname: Tomonari
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsui
authors.forename: Jong-Hon
authors.initials: JH
authors.lastname: Kang
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kodama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
keywords: elderly patient; hepatocellular carcinoma; long-term outcome; radiofrequency ablation