Safety and long-term outcomes of radiofrequency ablation therapy in elderly and cirrhotic patients with hepatocellular carcinoma K. Kakisaka 1 , H. Kuroda 1 , K. Kasai 1 , Y. Takikawa 1 , K. Suzuki 1 1 Iwate Medical University Background and Purpose: A tendency of the aging in patients with hepatocellular carcinoma (HCC) is predominantly seen in Japan. In fact, the mean age of patients with HCC in our institute in 1990 was 60.1 years old, while that in 1999 was 67.8 years old. It is not still remained whether the percutaneous radiofrequency ablation (RFA) therapy in elder patients with HCC is safety and equal in therapeutic usefulness compared to the non-elder patients with HCC. Subjects and Methods: Two hundred six cirrhotic patients with HCC (376 tumor nodules) received RFA therapy curative intent since August, 2006 were enrolled. We divided all patients into two groups: over 65 years (elder group: n=135) and under 65 years (non-elder group: n=71), and compared the patient's characteristics, tumor factors and survival rate and causes of death in two groups. Results: The characteristics of patients, tumor factors, cumulative survival rate and recurrence rate were not revealed in two groups. Although in elder group two patients complicated aspiration pneumonia and respiratory depression due to sedation under RFA respectively, total occurrence rate of complications did not differ between two groups. Conclusion: RFA therapy is safety and effective even in elder patients with HCC, although their care is necessary to prevent any complications which are often occurred during the RFA therapy. Background and Purpose: The aim of this study is to evaluate whether administration of the branched-chain amino acid (BCAA) enriched nutrient (namely, aminoleban EN, Ostuka Pharmaceutical Company, Japan) might improve protein-energy malnutrition (PEM) status and quality of life (QOL) in cirrhotic patients with HCC receiving RFA therapy. Subjects and Methods: Thirty-five cirrhotic patients with HCC who had received RFA therapy from October 2005 to October 2006 in our institute were randomized into two groups: diet with supplementation of aminoleban EN (EN group: 20 patients, 420 kcal/day) and diet only (control group; 15 patients). The total intakes of calories (30-35 kcal/kg) and protein (1.0-1.5 g/kg) were equal between tow groups. The primary end point was event-free survival rate (development of liver cancer, rupture of esophageal varices, or progression of hepatic failure) and second end points were serum albumin levels and the health-related QOL by ShortForm-8 questionnaire (SF-8). Results: Total intakes of calories and protein were similar during the one year after RFA. No significant differences in event-free survival rate were seen between two groups. However, decreased serum albumin levels and one (general health perception) of domains in SF-8 were significantly improved in EN group compared to the control group. Conclusion: Supplementation of BCAA-enriched nutrient may improve the impaired liver function and QOL after RFA therapy. Large scale prospective study should conduct to confirm these results near the future. 