Background:Although radiofrequency ablation(RFA)is a minimally invasive treatment for early-stage hepatocellular carcinoma(HCC),it remains unclear whether RFA achieves favorable outcomes in pa-tients aged ≥80 years.This study aimed to determine the efficacy and safety of RFA for HCC in patients aged ≥80 years. Methods:A total of 512 naive patients with HCC who had undergone RFA from January 2001 to December 2016 were enrolled.They were categorized into the ≥80-year-old group and the control group(aged ＜80 years).The primary endpoint was overall survival(OS),and the secondary endpoints were recurrence-free survival,complications associated with RFA,and cause of death.Propensity score matching was performed to adjust for patients'sex,liver function,tumor number,tumor diameter,and hepatitis C virus infection.Finally,the data of 68 patients in the ≥80-year-old group and 68 in the control group were analyzed;their baseline characteristics,primary endpoint,and secondary endpoints were compared. Results:There were significant differences in the alanine aminotransferase level and prothrombin time between the groups.The cumulative OS rate was not significantly different between the groups(P=0.83):98.5％,87.9％,and 50.5％ in the ≥80-year-old group and 94.1％,72.8％,and 49.3％ in the control group at 1,3,and 5 years,respectively.Age ≥80 years was not significantly associated with OS in multivariate analyses.Liver-related death occurred in 17 patients in the ≥80 year-old group and in 16 patients in the control group(P=1.00). Conclusions:RFA is safe and effective for the treatment of patients with HCC aged ≥80 years.