Predictive Value of Age-Adjusted Charlson Comorbidity Index on Survival Outcomes of Hepatocellular Carcinoma Patients with Comorbidities Undergoing Radiofrequency Ablation.

[PURPOSE] This study aimed to explore the predictive value of Age-Adjusted Charlson Comorbidity Index (ACCI) on survival outcomes in patients with hepatocellular carcinoma (HCC) and comorbidities undergoing radiofrequency ablation (RFA).

[MATERIALS AND METHODS] This study is a retrospective, single-center study which included 158 patients with HCC newly diagnosed at our center from January 2015 to December 2021 who had comorbidities prior to RFA treatment. Patients were divided into two groups (≤4 and >4) according to the optimal cutoff value of ACCI determined by X-tile analysis based on overall survival (OS), and comprehensive clinical, laboratory, and tumor characteristic data were collected. The primary endpoints were OS and recurrence-free survival (RFS), analyzed using the Kaplan-Meier method and Cox proportional hazards model.

[RESULTS] Patients in the high ACCI group (>4) were independently associated with worse OS and RFS compared to those in the low ACCI group (≤4). Multivariate Cox analysis confirmed that ACCI >4 was an independent risk factor for both OS and RFS, with hazard ratios (HR) of 2.07 and 2.05, respectively. In addition to ACCI, other independent predictors for worse OS included tumor max-diameter (HR: 1.69, P < 0.001) and elevated level of preoperative α-fetoprotein (HR: 1.91, P = 0.007), while preoperative albumin (HR: 0.93, P=0.001) was a significant protective factor for OS. For RFS, significant risk factors included tumor max-diameter (HR: 1.79, P < 0.001) and prothrombin time ≥ 13 seconds (HR: 2.38, P = 0.001).

[CONCLUSION] ACCI may serve as a useful prognostic predictor for survival outcomes in HCC patients with comorbidities undergoing RFA.