Saudi Journal of Gastroenterology
Home About us Instructions Submission Subscribe Advertise Contact Login    Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Users Online: 795 
Year : 2018  |  Volume : 24  |  Issue : 6  |  Page : 317-325

Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage

1 Department of Hepatobiliary and Laparoscopic Surgery, Renmin Hospital of Wuhan University, Wuhan, China
2 Department of General Surgery, Xiangyang Central Hospital, Xiangyang, China
3 Department of Pathology and Pathophysiology, Wuhan University School of Basic Medical Sciences, Wuhan, China

Correspondence Address:
Prof. Youming Ding
Department of Hepatobiliary and Laparoscopic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjg.SJG_261_18

Rights and Permissions

Background/Aims: To compare the survival benefits of surgical resection (SR) with those of radiofrequency ablation (RFA) in elderly patients (≥65 years) with single hepatocellular carcinoma (HCC) ≤5 cm. Patients and Methods: Using the Surveillance, Epidemiology, and End Results database, a total of 461 patients who underwent SR and 575 patients who underwent RFA were enrolled from 2004 to 2012. Overall survival (OS) and liver-cancer-specific survival (LCSS) comparisons were conducted between the two groups before and after propensity score matching (PSM).Results: Elderly patients with early-stage HCC had a lower rate of utilization of liver transplantation, and they were more likely to receive SR or RFA as their first-line treatment compared with younger patients (P < 0.05). In the whole cohort, the SR group had significantly better OS [RFA, hazard ratio (HR) = 1.680 (1.390, 2.031), P < 0.001] and LCSS (RFA, HR = 1.658 (1.327, 2.070), P < 0.001) than the RFA group. After PSM, the improved survival in the SR group was further confirmed (all P < 0.001). In the subgroup analyses, according to patients' age (65–75, >75 years) and tumor size (≤3.0, 3.1–5.0 cm), the SR group still presented better OS and LCSS than the RFA group (all P < 0.05), except for those older than 75 years with tumors ≤3.0 cm (all P > 0.05), both before and after PSM. Conclusion: Treatment strategies for elderly patients (≥65 years) with single HCC ≤5 cm should emphasize SR as the primary therapy, while RFA can be an alternative to SR for those >75 years with single HCC ≤3 cm.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded392    
    Comments [Add]    

Recommend this journal