ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
This article is part of the Research TopicThe Contrast Enhanced Ultrasound and Ultrasound Cavitation in the Diagnostic and Therapeutic Application of Solid TumorView all 4 articles
Efficacy and Safety of High-Intensity Focused Ultrasound Ablation Under General Anesthesia in Older Hepatocellular Carcinoma Patients
Provisionally accepted
- Clinical Center for Tumor Therapy, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Older patients often have comorbidities, leading to a higher risk of delayed recovery while under general anesthesia. High-intensity focused ultrasound (HIFU) for patients with hepatocellular carcinoma (HCC) usually requires general anesthesia to alleviate procedure-related pain and ensure immobilization. This study aimed to evaluate the safety and efficacy of HIFU for the treatment of older patients with HCC, and to explore the associated prognosis and risk factors. Methods: A total of 174 patients with HCC who underwent HIFU were enrolled in this study and divided into three age groups: <60 years (n=100), 60–74 years (n=55), and ≥75 years (n=19). The risks of general anesthesia associated with HIFU were observed, and the ablation effects of HIFU were evaluated using contrast-enhanced CT or MRI. Survival analysis, prognosis and risk factors were analyzed. Results: The prevalence of comorbidities was 73.68%, 52.72%, and 26.00% in patients aged ≥75 years, 60–74 years, and <60 years, respectively. The difference between the three groups was significant (P < 0.001). The rates of complete response (CR), partial response (PR), and ORR were 25.61%, 46.34%, and 71.95% in patients aged <60 years, 34.04%, 40.42%, and 74.46% in patients aged 60–74 years, and 12.50%, 62.50%, and 75.00% in patients aged ≥75 years, respectively. 1-year and 2-year overall survival (OS) rates in patients aged <60, 60–74, and ≥75 years were 78.4% and 70.5%, 84.5% and 75.3%, and 72.4% and 43.4%, respectively. There were no significant differences in ORR and OS between the three groups (P = 0.937 and 0.055, respectively). No significant difference of the median interval time of anesthesia recovery between three groups occurred (P = 0.208) and no other anesthesia-related complications were observed. CNLC stage Ⅲ was an independent prognostic factor (P = 0.049). AFP ≥20 ng/mL was an independent risk factor (P = 0.016), whereas the combination of other local treatment methods was a protective factor (P = 0.016). Conclusions: HIFU ablation under general anesthesia for older HCC patients is safe, feasible and effective
Keywords: ablation, Acoustic Therapy, older patients, Hepatocellular Carcinoma, High-intensity focused ultrasound
Received: 09 Sep 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Xie, Ran, Yang, Zhou, Jin and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chengbing Jin
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.