Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Hepatol Res. 2014 Oct;44(11):1095-101. doi: 10.1111/hepr.12233. Epub 2013 Oct 25.
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.
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.
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).
RFA in elderly patients is as effective and safe as in non-elderly patients for the treatment of HCC.
射频消融术（RFA）在老年肝细胞癌（HCC）患者中的应用正在增加。本研究比较了 RFA 疗效和安全性方面老年（≥75 岁）与非老年（<75 岁）患者的结果。
纳入了 1999 年至 2012 年期间接受 RFA 治疗的 335 例初治 HCC 患者，其中 103 例为老年患者，232 例为非老年患者。分析了患者特征、并发症、住院时间、总生存期（OS）、中位生存期（MST）、无复发生存期（RFS）以及与 OS 相关的因素。
老年组患者的中位年龄为 79 岁（范围为 75-88 岁），非老年组为 65 岁（38-74 岁）。与非老年组相比，老年组女性（45.6%比 28.0%）、丙型肝炎病毒感染（63.1%比 50.4%）和合并症（78.6%比 44.0%）的比例更高。两组间并发症和住院时间无差异。老年组 5 年 OS 率和 MST 分别为 67.3%和 90.5 个月，非老年组分别为 60.9%和 86.4 个月（P=0.486）。老年组的中位 RFS 时间为 20 个月，非老年组为 18.7 个月（P=0.429）。多因素分析显示，Child-Pugh 分级和肿瘤-淋巴结-转移分期与 OS 显著相关（P<0.001，P=0.003）；年龄无相关性（P=0.355）。
RFA 治疗 HCC 时，老年患者与非老年患者一样有效且安全。
