Long-term outcomes of thermal ablation vs surgical resection for single small hepatocellular carcinoma
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND Thermal ablation (TA), including radiofrequency ablation and microwave ablation, is a commonly used curative treatment for single small hepatocellular carcinoma (sHCC). The relative advantages of TA and surgical resection (SR) in terms of long-term survival remain controversial. AIM To compare their long-term efficacy in this patient population. METHODS This population-based retrospective cohort study included 257 patients who received a first diagnosis of single sHCC and underwent SR or TA from January 2012 to September 2017. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS). RESULTS The average follow-up duration was 11.4 years. The 1-, 3-, 5-, and 10-year OS rates were 95.8%, 86.0%, 82.5%, and 74.2% in the SR group vs 97.4%, 85.8%, 78.6%, and 65.6% in the TA group, with the median OS not yet reached. The 1-, 3-, 5-, and 10-year RFS rates were 79.8%, 59.6%, 46.2%, and 24.7% in the SR group vs 83.9%, 61.5%, 47.9%, and 41.2% in the TA group, with median RFS values of 3.95 and 4.63 years, respectively. No significant differences in OS or RFS were observed overall (OS: P = 0.244; RFS: P = 0.180), but in patients ≤ 60 years, TA led to a higher RFS than SR (P = 0.021). Multivariate analysis identified age, tumor differentiation grade, and Child-Pugh classification as independent risk factors for OS, whereas age and differentiation grade were significant risk factors for RFS. CONCLUSION In patients with single sHCC, SR, and TA offered comparable long-term efficacy. However, TA showed superior RFS in patients ≤ 60 years, suggesting that TA may be a reasonable option for younger patients, pending confirmation by prospective studies.
Authors: Ying-Ming Gao, Sai-Kang Tang, Zhi-Wen Luo, Wei-Hua Zhi, Xue Yan, Xin Yin, Xin-Yu Bi, Yue Han
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416441511