Objective       To evaluate the efficiency of radiofrequency ablation (RFA) for elderly hepatocellular carcinoma (HCC) patients conforming to the Milan criteria.       Methods       A retrospective study was adopted to analyze the clinical data of 90 cases of HCC patients

aged ≥70 years and conforming to the Milan criteria

treated with RFA initially. All patients were followed up for once per 1 to 3 months

for an average time of 37.63 months. The rate of overall survival (OS) and disease free survival (DFS) in 1

2

3

4 and 5 years after initial RFA were statistically analyzed. Then the factors contributing to overall survival and recurrence-free survival after initial RFA were analyzed.       Results       In the cohort of 90 patients

31 (34.44%) had complications after RFA

and no severe complication or death was observed. The median of DFS was 21 months. The DFS rates of 1

2

3

4 and 5 years after initial RFA were 65.56%

46.67%

33.33%

24.44% and 17.78%

respectively. The median of OS was 49 months. The OS rates of 1

2

3

4 and 5 years after initial RFA were 91.11%

80.00%

67.78%

52.22%

and 35.56%

respectively. In the multivariate analysis

long-term drinking

hepatoviral infection

cirrhosis

Child-Pugh grade B

alpha fetoprotein (AFP) ＞20 ng/ml

HBV-DNA ＞1 000 copies/mL

serum creatinine ＞88.4 μmol/L

and comorbid diseases were significant risk factors influencing survival rate. For the patients with single focus with size larger than 3 cm

their DFS and OS rates were significant lower.       Conclusion       RFA is safe

effective and of less complication for elderly HCC patients confirming to the Milan criteria. The patients with tumor size ＞3 cm have poor prognosis after RFA. However

RFA is a good option for elderly patients.