- Patients with early- or very early-stage hepatocellular carcinoma (HCC) aged >65 years had better OS with resection if their tumors were 21-50 mm. There was no survival advantage for resection over radiofrequency ablation (RFA) in elderly with tumors ≤20 mm.
- In patients ≤65 years, resection produced better OS regardless of tumor size.
Why this matters
- The study is the first to compare hepatic resection (HR) and RFA in patients aged >65 and ≤65 years in a large sample and subdivided by tumor size.
- Retrospective cohort drawn from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015, n=6076).
- Funding: Various nonindustry sources.
- In patients aged >65 years, after propensity score matching:
- Tumors ≤20 mm: RFA and HR were associated with similar 3- and 5-year OS and disease-specific survival (DSS).
- Tumors 21-30 mm: 3- and 5-year OS was better in the HR group (aHR, 1.30; P=.03). 3- and 5-year DSS did not differ significantly.
- Tumors 31-50 mm: 3- and 5-year OS was better in the HR group (aHR, 2.00; P<.001 as was dss p>
- In patients aged ≤65 years, after propensity score matching:
- OS and DSS were significantly better with HR than with RFA in all tumor sizes.
- Retrospective analysis.