Abstract
Purpose: This study aimed to evaluate the efficacy and overall clinical outcome of patients over the age of 80 undergoing stereotactic radiofrequency ablation (SRFA) and to compare the results to a younger population with propensity score matching.Materials and Methods: Between 2006 and 2018 36 patients aged between 80 and 90 years underwent 46 SRFA sessions of 70 primary and secondary liver tumors. For comparison of treatment safety and efficacy 36 younger patients were selected with propensity score matching by the R package “MatchIt” in this retrospective, single-center study.Results: 68/70 tumors were successfully ablated at first ablation session (97% primary technical efficacy rate). Local tumor recurrence developed in 5 of 70 nodules (7.1%). The complication rate above Clavien-Dindo Grade III was 6.5% (3 of 46). The overall survival (OS) rates at 1-, 3-, and 5- years from the date of the first SRFA were 84.6, 50.5, and 37.9% for HCC patients and 87.5%, 52.5% at 1-, and 3-years for CRC patients. The disease-free survival (DFS) for HCC patients after SRFA was 79.1, 35.6, and 23.7%, at 1-, 3-, and 5- years, and 75%, 22.5% at 1-, and 3-years for CRC patients. There were no significant differences in terms of technical efficacy, local recurrences, major complications, OS and DFS compared to the control group.Conclusion: SRFA in octogenarians is a safe, feasible and useful option in the management of primary or metastatic liver tumors with no significant difference in outcomes compared to a younger control group.
Highlights
Worldwide the population is aging [1] due to rising living standards and life expectancy
This loss of independence is a result of the stereotactic radiofrequency ablation (SRFA) of Liver Tumors in Octogenarians acute condition that lead to admission, and substantially related to the duration and mode of management [4,5,6]
At first SRFA, 24 patients had a solitary tumor in the liver, 8 had two tumors, 3 had three tumors, and one patient had more than three tumors
Summary
Worldwide the population is aging [1] due to rising living standards and life expectancy. In Austria, the number of people older than 80 years increased from 280,000 (3.6% of the population) in 2000 to 450,000 (5.4% of the population) in 2017 [3] With this trend, the incidence of co-morbidities and malignancies rise in a larger cohort of patients. Hospitalization of older patients is commonly followed by an irreversible decline in functional status, i.e., losing independence in basic activities of daily living. This loss of independence is a result of the SRFA of Liver Tumors in Octogenarians acute condition that lead to admission, and substantially related to the duration and mode of management [4,5,6]. Postoperative delirium occurs in 15–53% [7] of older patients after surgical treatment and its incidence can reach 70–87% [8] among patients admitted to postoperative intensive care unit
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