Abstract
It is unclear whether overall survival (OS) differs by age for patients with early‐stage hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). We aim to clarify this issue. All patients diagnosed with early‐stage HCC (i.e., within Milan criteria) and Child–Pugh class A liver disease undergoing RFA between 2011 and 2021 were enrolled. Patients with incomplete ablation were excluded. This study enrolled 791 patients and them divided into four groups by age: <70 years (Group 1, n = 508), 70–74 years (Group 2, n = 122), 75–79 years (Group 3, n = 102), and ≥80 years (Group 4, n = 59). The five-year OS was 65% in Group 1, 60% in Group 2, 53% in Group 3, and 38 % in Group 4 (p = 0.009). With Group 4 as the reference, multivariate analysis indicated that Groups 1 (HR: 0.496, 95% CI: 0.314–0.785, p = 0.003) and 3 (HR: 0.496, 95% CI: 0.277–0.889, p= 0.018) but not Group 2 (HR: 0.689, 95% CI: 0.403–1.179, p = 0.174) were independent factors associated with superior five-year OS. In conclusion, among patients with early-stage HCC and Child–Pugh class A liver disease undergoing RFA, those aged ≥80 years had inferior five-year OS.