RFA yields better outcomes than resection in elderly patients with early HCC
Radiofrequency ablation for early or very early hepatocellular carcinoma yielded similar survival rates but was more effective and safer than open resection among older patients in a recent study.
In a retrospective comparative study in China, researchers evaluated the overall and recurrence-free survival rates of 180 patients aged older than 65 years with early or very early hepatocellular carcinoma who underwent radiofrequency ablation (RFA; n=89) or open hepatic resection (HR; n=91) as initial therapy at a single facility between January 2003 and January 2007. Follow-up was performed for a median of 41 months among RFA recipients and 39 months in the HR group.
Overall survival rates at 1 (93.2% for RFA vs. 88.8% for HR), 3 (71.1% and 62.8%) and 5 years (55.2% and 51.9%) did not significantly differ between groups (P=.305). Recurrence-free survival was significantly more common, however, among RFA recipients (84.1% at 1 year, 62.7% at 3 and 35.5% at 5 years vs. 76.7%, 39.3% and 33.1%; P=.035). Multivariate analysis indicated that, of all evaluated variables, only the performed treatment type was predictive of recurrence-free survival (HR=1.502; 95% CI, 1.021-2.209).
Analysis restricted to patients with tumors 3 cm or smaller indicated significantly better overall (P=.038) and recurrence-free survival (P=.049) in the RFA group. Among patients with tumors larger than 3 cm, no difference was observed between groups in overall or recurrence-free survival.
Significantly fewer RFA recipients than HR recipients experienced fever greater than 38.5°C (P=.014), higher-grade pain (P=.025), ascites (P<.001), hepatic failure (P=.004) and pleural effusion (P=.004) post-treatment. Hospital stay also was significantly shorter in the RFA group (8.01 ± 2.7 days vs. 13.5 ± 4.05 days; P<.001).
“Our study is the first to compare the efficacy and safety between RFA and open HR for elderly patients with HCC,” the researchers concluded. “RFA was efficacious and safe for elderly patients with HCC within the very early or early stage. The results were especially good for patients with HCC smaller than 3 cm.”
Disclosure: The researchers report no relevant financial disclosures.