Background/Aim The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.
Citations
Citations to this article as recorded by
Asian Conference on Tumor Ablation Guidelines for Hepatocellular Carcinoma Shuichiro Shiina, Ryosuke Tateishi, Joon Il Choi, So Yeon Kim, Zhiqiang Meng, Lujun Shen, Sheng-Nan Lu, Jen-I. Hwang, Maki Tobari, Hitoshi Maruyama, Terguunbileg Batsaikhan, Qing Deng, Lariza Marie Canseco, Yoshinari Asaoka, Shi-Ming Lin, Kai-Wen Huang, H Liver Cancer.2025; 14(5): 651. CrossRef
Reply to the Letter regarding “Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study” Kazuhiro Nouso, Kazuya Kariyama Journal of Liver Cancer.2024; 24(1): 5. CrossRef
Radiofrequency for hepatocellular carcinoma larger than 3 cm: potential for applications in daily practice Ji Hoon Kim, Pil Soo Sung Journal of Liver Cancer.2024; 24(1): 1. CrossRef
Letter regarding “Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study” Jongman Kim Journal of Liver Cancer.2024; 24(1): 3. CrossRef