S1905 Efficacy of Radiofrequency Ablation for Early Stage Hepatocellular Carcinoma

Abstract

Background and aims: The patient with hepatocellular carcinoma (HCC) diagnosed for the first time was gradually older year by year in spite of the etiology in Japan. Recently the HCC naive patients diagnosed at the age over 80 years old were not rarely found. In that case, the indication of the treatment of patient with HCC was supposed to be difficult due to the liver function and their complication. The aim of this study was to assess the liver function and the prognosis of its treatment of the naive patient with HCC over 80years old. Methods: During 8years(2001~2008), 538patients (203woman and 335man) had been diagnosed for the first time as HCC by ultrasonograpy, computed tomography and magnetic resonance imaging and admitted to our hospital for the treatment. These patients were examined blood test and were performed thepatic resection, percutanous radiofrequency ablation (RFA), transcatheter chemoemblization (TACE) or conservative treatment. We classified the patients in two groups, group A: =80 years old, according to the age diagnosed for the first time, and assessed the clinical data between two groups. Results: Forty subjects (22woman and 18man, HBV:HCV:NBNC=3:28:9) out of 538HCC naive patients (7.4%, HBV:HCV:NBNC=82:383:73) were over 80years old. Women and NBNC cases were more found in the group B (p<0.05). The average age of HCC diagnosis was as follows according to the etiology, 2001; HBV:56.6y.o., HCV:66.9y.o., 2004; HBV:57.6y.o., HCV:68.4y.o., 2008; HBV:61.4y.o., HCV:70.0y.o.. Tumor size was, group A;3.1+/-2.4cm, groupB;3.6+/-2.9cm(n.s.), ICGR15 was, groupA;28.1+/-16.9%, groupB;25.0+/-10.4%(n.s.) and serum ALT levels was group A;56.2+/-39.8cm, groupB;53.9+/-26.6IU/L(n.s.). Statistical significant differentiation was not found between two groups in the Child-Pugh score, Liver staging and over all survival. In 40 subjects over 80years old, the treatment was as follows; Hepatic resection;10, RFA; 2, TACE;22, conservative treatment; 6 and the better over all survival rate was found in the case of hepatic resection or RFA than other treatment (p<0.05). Conclusions: This study showed that, even in the HCC naive patient over 80 years old, the hepatic resection or RFA could be the best indication as the prognosis appears to be good, and that we should provide more intensive care to patients over 80 years old with high serum ALT levels.