{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:09:52Z","timestamp":1782439792609,"version":"3.54.5"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 174 patients with HCC who underwent HIFU were enrolled in this study and divided into three age groups: &amp;lt;60 years (n=100), 60\u201374 years (n=55), and \u226575 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of comorbidities was 73.68%, 52.72%, and 26.00% in patients aged \u226575 years, 60\u201374 years, and &amp;lt;60 years, respectively. The difference between the three groups was significant (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The rates of complete response (CR), partial response (PR), and ORR were 25.61%, 46.34%, and 71.95% in patients aged &amp;lt;60 years, 34.04%, 40.42%, and 74.46% in patients aged 60\u201374 years, and 12.50%, 62.50%, and 75.00% in patients aged \u226575 years, respectively. 1-year and 2-year overall survival (OS) rates in patients aged &amp;lt;60, 60\u201374, and \u226575 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 (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.937 and 0.055, respectively). No significant difference of the median interval time of anesthesia recovery between three groups occurred (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.208) and no other anesthesia-related complications were observed. CNLC stage III was an independent prognostic factor (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.049). AFP \u226520 ng\/mL was an independent risk factor (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.016), whereas the combination of other local treatment methods was a protective factor (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HIFU ablation under general anesthesia for older HCC patients is safe, feasible and effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1702332","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T05:19:38Z","timestamp":1765430378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy and safety of high-intensity focused ultrasound ablation under general anesthesia 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