Partial liver resection results in a significantly better long-term survival than locally ablative procedures even in elderly patients

Abstract

In patients aged 70 years and over, long-term prognosis is independently influenced by CLIP score and treatment procedure and other findings have only minor influence on long-term survival.

Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?

“…In the comparison of RFA and surgical resection by postoperative outcomes, contradictory results were yielded. Peng et al[73] reported that patients having RFA had better outcomes than those having surgical resection, while Bauschke et al[74] and Yu et al[75] reported better outcomes for surgical resection. Another retrospective study by Jiang et al[76] concluded that RFA should be recommended for elderly patients (age > 65 years) with HCCs ≤ 20 mm while surgical resection would be a better treatment for HCCs of 21-50 mm in elderly patients.…”

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

“…demonstrated that SR ( n = 63) resulted in significantly better long-term survival rates than RFA ( n = 64) in elderly patients (≥70 years) with early-stage HCC ( P < 0.05). [ 12 ] The controversy between the two studies is obvious, as are their limitations, such as small sample size, selection bias, lack of histological diagnosis, or subgroup analyses. Therefore, this large population-based retrospective study was conducted using PSM analysis to compare the different survival outcomes of SR ( n = 461) and RFA ( n = 575) in elderly patients (≥65 years) with single HCC ≤5 cm.…”

“…[ 11 ] Hence, for elderly patients with early-stage HCC who are candidates for both SR and RFA, it remains controversial which treatment provides better long-term survival outcomes. [ 12 13 ] We therefore compared the survival benefits of SR with those of RFA as the first-line treatment in elderly patients (≥65 years) with single HCC ≤5 cm using Surveillance, Epidemiology, and End Results (SEER), a large population-based database.…”

Surgical resection vs radiofrequency ablation in older adults with early stage hepatocellular carcinoma: Where do we stand?

“…[ 2 3 ] However, SR may provide a greater long-term survival benefit compared to RFA among HCC patients. [ 4 ]…”

“…Despite the study limitations which include study design, missing data such as the Child-Pugh score, performance status, patients' comorbidities, tumor characteristics, and location, it has a reasonable sample size and is consistent with what has been published in the literature regarding the safety and efficacy of RFA and SR group in elderly HCC patients. [ 4 6 ] However, more high-quality studies are required to validate the result. Yet, research such as this helps to inform multidisciplinary patient-centered decision making to personalize treatment based on liver dysfunction, tumor size, tumor number, comorbidities, and performance status.…”