Abstract
The feasibility and safety of microwave ablation in elderly hepatocellular carcinoma (HCC) patients remains unknown. The aim of this study was to evaluate the feasibility and safety of surgical microwave ablation for HCC in patients older than 80 years of age. This retrospective study enrolled consecutive 114 patients older than 80 years of age who underwent surgical microwave ablation for HCC between July 1994 and December 2017. We analyzed perioperative outcomes and long-term outcomes to clarify the prognostic factors. The 1-, 3-, 5-year overall survival and recurrence-free survival rates were 97.3%, 76.0%, 49.2% and 84.2%, 44.7%, and 32.5%, respectively. The overall major morbidity rates (Clavien–Dindo grade IIIA or above) were 2.6%. There were no cases of mortality. Multivariate analysis showed that hepatitis C virus antibody (HCV-Ab) positivity and the presence of multiple tumors were independent prognostic factors for long-term outcomes. The overall survival rate of patients with HCV-Ab negative and single tumor was better than that of other patients (p = 0.026). Surgical microwave ablation was feasible and safe for elderly patients with HCC. Elderly patients with HCV-Ab negative and single tumor would be expected to have better long-term outcomes after surgical microwave ablation.
Highlights
The feasibility and safety of microwave ablation in elderly hepatocellular carcinoma (HCC) patients remains unknown
This study investigated the feasibility and safety of surgical microwave ablation in elderly HCC patients (≥ 80 years)
Our study revealed that surgical microwave ablation was performed feasibly and safely in elderly patients with primary HCC, who had a 5-year Overall survival (OS) rate of 49.2%
Summary
The feasibility and safety of microwave ablation in elderly hepatocellular carcinoma (HCC) patients remains unknown. Patients with HCV-Ab negative and single tumor would be expected to have better long-term outcomes after surgical microwave ablation. Abbreviations HCC Hepatocellular carcinoma HCV-Ab Hepatitis C virus antibody RFA Radiofrequency ablation MCN Microwave coagulo-necrotic therapy ASA classification American Society of Anesthesiologists classification HBs-Ag Hepatitis B surface antigen ICG-R15 Indocyanine green retention rate at 15 min AFP Alpha-fetoprotein DCP Des-γ-carboxy prothrombin OS Overall survival RFS Recurrence-free survival SVR Sustained virological response HR Hazard ratio CI Confidence interval DAA Direct-acting antiviral agents. We have performed surgical microwave ablation, termed microwave coagulo-necrotic therapy (MCN), for primary HCC and for recurrent HCC since 1988, and reported its feasibility, safety and oncological long-term outcomes p reviously[14,15,16,17]. The feasibility and safety of microwave ablation in elderly HCC patients remains unknown
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