Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage
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...
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| 格式: | 文件 |
| 语言: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| 丛编: | The Saudi Journal of Gastroenterology |
| 主题: | |
| 在线阅读: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2018;volume=24;issue=6;spage=317;epage=325;aulast=Yu |
| _version_ | 1828161825608302592 |
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| author | Bin Yu Youming Ding Xiaofeng Liao Changhua Wang Bin Wang Xiaoyan Chen |
| author_facet | Bin Yu Youming Ding Xiaofeng Liao Changhua Wang Bin Wang Xiaoyan Chen |
| author_sort | Bin Yu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T00:45:12Z |
| format | Article |
| id | doaj.art-ab1faba3b51c4ecb983dda8befc4fac3 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-04-12T00:45:12Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-ab1faba3b51c4ecb983dda8befc4fac32022-12-22T03:54:54ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492018-01-0124631732510.4103/sjg.SJG_261_18Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortageBin YuYouming DingXiaofeng LiaoChanghua WangBin WangXiaoyan ChenBackground/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.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2018;volume=24;issue=6;spage=317;epage=325;aulast=YuElderly patientshepatocellular carcinomaprognosisradiofrequency ablationsurgical resection |
| spellingShingle | Bin Yu Youming Ding Xiaofeng Liao Changhua Wang Bin Wang Xiaoyan Chen Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage The Saudi Journal of Gastroenterology Elderly patients hepatocellular carcinoma prognosis radiofrequency ablation surgical resection |
| title | Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage |
| title_full | Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage |
| title_fullStr | Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage |
| title_full_unstemmed | Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage |
| title_short | Radiofrequency ablation versus surgical resection in elderly patients with early-stage hepatocellular carcinoma in the era of organ shortage |
| title_sort | radiofrequency ablation versus surgical resection in elderly patients with early stage hepatocellular carcinoma in the era of organ shortage |
| topic | Elderly patients hepatocellular carcinoma prognosis radiofrequency ablation surgical resection |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2018;volume=24;issue=6;spage=317;epage=325;aulast=Yu |
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