Abstract | GOALS: BACKGROUND: Whether age plays an important role in the outcomes of HCC after RFA remains controversial. STUDY: Two hundred fifty-eight consecutive treatment naive HCC patients who underwent RFA were enrolled. Patients aged ≤ 65 years (n = 100) were defined as the younger group and those aged > 65 years (n = 158) were the elderly group. Their clinicopathologic features and prognosis were compared. RESULTS: Younger patients had a higher male-to-female ratio, higher prevalence of hepatitis B virus, and smaller tumor size than elder patients. After median follow-up of 28.5 ± 18.7 months, 45 patients died. The cumulative 5-year survival rates were 81.3% and 65.4% in younger and elder HCC patients, respectively (P = 0.008). Multivariate analysis disclosed that age > 65 years, serum albumin level ≤ 3.7 g/dL, prothrombin time international normalized ratio > 1.1, α- fetoprotein (AFP) > 20 ng/mL, and no antiviral therapy after RFA were independent risk factors associated with poor overall survival. Besides, there were 163 patients with tumor recurrence after RFA. Multivariate analysis showed that age > 65 years, platelet count ≤ 10/mm, AFP > 20 ng/mL, multinodularity, and tumor size > 2 cm were the independent risk factors predicting recurrence. CONCLUSIONS: Both liver functional reserve ( serum albumin level, prothrombin time international normalized ratio, platelet count, and antiviral therapy) and tumor factors ( tumor size, number, and AFP level) were crucial in determining post-RFA prognosis in HCC patients. Moreover, younger HCC patients have better overall survival and lower recurrence rate after RFA compared with elder patients.
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Authors | Wei-Yu Kao, Yi-You Chiou, Hung-Hsu Hung, Chien-Wei Su, Yi-Hong Chou, Teh-Ia Huo, Yi-Hsiang Huang, Wen-Chieh Wu, Han-Chieh Lin, Shou-Dong Lee, Jaw-Ching Wu |
Journal | Journal of clinical gastroenterology
(J Clin Gastroenterol)
Vol. 46
Issue 1
Pg. 62-70
(Jan 2012)
ISSN: 1539-2031 [Electronic] United States |
PMID | 21934530
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Age Factors
- Aged
- Aged, 80 and over
- Carcinoma, Hepatocellular
(pathology, surgery)
- Catheter Ablation
(methods)
- Cohort Studies
- Female
- Follow-Up Studies
- Humans
- Liver Neoplasms
(pathology, surgery)
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local
- Prevalence
- Prognosis
- Retrospective Studies
- Risk Factors
- Sex Factors
- Survival Rate
- Treatment Outcome
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