RT Journal Article T1 Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria. A1 Conticchio, Maria A1 Inchingolo, Riccardo A1 Delvecchio, Antonella A1 Laera, Letizia A1 Ratti, Francesca A1 Gelli, Maximiliano A1 Anelli, Ferdinando A1 Laurent, Alexis A1 Vitali, Giulio A1 Magistri, Paolo A1 Assirati, Giacomo A1 Felli, Emanuele A1 Wakabayashi, Taiga A1 Pessaux, Patrick A1 Piardi, Tullio A1 di Benedetto, Fabrizio A1 de'Angelis, Nicola A1 Briceño, Javier A1 Rampoldi, Antonio A1 Adam, Renè A1 Cherqui, Daniel A1 Aldrighetti, Luca Antonio A1 Memeo, Riccardo K1 Elderly patients K1 Hepatocellular carcinoma K1 Milan criteria K1 Propensity score matching K1 Radiofrequency ablation K1 Surgical resection AB Surgical resection and radiofrequency ablation (RFA) represent two possible strategy in treatment of hepatocellular carcinoma (HCC) in Milan criteria. To evaluate short- and long-term outcome in elderly patients (> 70 years) with HCC in Milan criteria, which underwent liver resection (LR) or RFA. The study included 594 patients with HCC in Milan criteria (429 in LR group and 165 in RFA group) managed in 10 European centers. Statistical analysis was performed using the Kaplan-Meier method before and after propensity score matching (PSM) and Cox regression. After PSM, we compared 136 patients in the LR group with 136 patients in the RFA group. Overall survival at 1, 3, and 5 years was 91%, 80%, and 76% in the LR group and 97%, 67%, and 41% in the RFA group respectively (P = 0.001). Disease-free survival at 1, 3, and 5 years was 84%, 60% and 44% for the LR group, and 63%, 36%, and 25% for the RFA group (P = 0.001).Postoperative Clavien-Dindo III-IV complications were lower in the RFA group (1% vs 11%, P = 0.001) in association with a shorter length of stay (2 d vs 7 d, P = 0.001).In multivariate analysis, Model for End-stage Liver Disease (MELD) score (> 10) [odds ratio (OR) = 1.89], increased value of international normalized ratio (> 1.3) (OR = 1.60), treatment with radiofrequency (OR = 1.46) ,and multiple nodules (OR = 1.19) were independent predictors of a poor overall survival while a high MELD score (> 10) (OR = 1.51) and radiofrequency (OR = 1.37) were independent factors associated with a higher recurrence rate. Despite a longer length of stay and a higher rate of severe postoperative complications, surgery provided better results in long-term oncological outcomes as compared to ablation in elderly patients (> 70 years) with HCC in Milan criteria. YR 2021 FD 2021 LK http://hdl.handle.net/10668/17822 UL http://hdl.handle.net/10668/17822 LA en DS RISalud RD Feb 15, 2025