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Purpose <p>Few studies have compared survival outcomes between liver resection (LR) and percutaneous radiofrequency ablation (RFA) for treating solitary 3–5 cm hepatocellular carcinoma (HCC). We aimed to clarify this issue.</p> Methods <p>Patients with Child–Pugh class A liver disease and a solitary HCC of 3–5&#xa0;cm without macrovascular invasion or extrahepatic metastasis who underwent LR or percutaneous RFA between 2011 and 2021 were enrolled in this retrospective study; 310 patients underwent LR and 114 patients underwent percutaneous RFA. Propensity score matching (PSM) was used to balance baseline variables, including age, sex, alpha-fetoprotein level, and Model for End-Stage Liver Disease score, between the two groups.</p> Results <p>Before PSM, 5-year overall survival (OS) and recurrence-free survival (RFS) were significantly lower in the percutaneous RFA group than in the LR group (both <i>p</i> &lt; 0.001). After PSM, 5-year OS was comparable between the two modalities (<i>p</i> = 0.367); however, 5-year RFS was significantly lower in the RFA group than in the LR group (<i>p</i> = 0.001). The two modalities did not differ in severe post-treatment complications (<i>p</i> = 1.000).</p> Conclusions <p>Five-year OS did not differ between treatment modalities for patients with a solitary HCC of 3–5&#xa0;cm; however, the LR group’s 5-year RFS was superior. LR should be recommended as the first-line treatment for these patients.</p>

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Overall survival is comparable between percutaneous radiofrequency ablation and liver resection as first-line therapies for solitary 3–5 cm hepatocellular carcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月12日

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  • Shih-Da Chung,
  • Chee-Chien Yong,
  • Kwong-Ming Kee,
  • Sheng-Nan Lu,
  • Tsung-Hui Hu,
  • Jing-Houng Wang,
  • Chao-Hung Hung,
  • Chien-Hung Chen,
  • Yueh-Wei Liu,
  • Wei-Feng Li,
  • Chih-Chi Wang,
  • Yi-Hao Yen,
  • Chih-Yun Lin

摘要

Purpose

Few studies have compared survival outcomes between liver resection (LR) and percutaneous radiofrequency ablation (RFA) for treating solitary 3–5 cm hepatocellular carcinoma (HCC). We aimed to clarify this issue.

Methods

Patients with Child–Pugh class A liver disease and a solitary HCC of 3–5 cm without macrovascular invasion or extrahepatic metastasis who underwent LR or percutaneous RFA between 2011 and 2021 were enrolled in this retrospective study; 310 patients underwent LR and 114 patients underwent percutaneous RFA. Propensity score matching (PSM) was used to balance baseline variables, including age, sex, alpha-fetoprotein level, and Model for End-Stage Liver Disease score, between the two groups.

Results

Before PSM, 5-year overall survival (OS) and recurrence-free survival (RFS) were significantly lower in the percutaneous RFA group than in the LR group (both p < 0.001). After PSM, 5-year OS was comparable between the two modalities (p = 0.367); however, 5-year RFS was significantly lower in the RFA group than in the LR group (p = 0.001). The two modalities did not differ in severe post-treatment complications (p = 1.000).

Conclusions

Five-year OS did not differ between treatment modalities for patients with a solitary HCC of 3–5 cm; however, the LR group’s 5-year RFS was superior. LR should be recommended as the first-line treatment for these patients.