Work

Comparative survival outcomes of laparoscopic liver resection and radiofrequency ablation for hepatocellular carcinoma: a retrospective propensity-score-matched cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: Laparoscopic liver resection (LLR) and radiofrequency ablation (RFA) are widely used treatment options for hepatocellular carcinoma (HCC). RFA is often preferred for patients with poor surgical tolerance, whereas LLR is generally associated with superior oncological outcomes. However, few studies have evaluated the impact of treatment choice on both short- and long-term survival. MATERIALS AND METHODS: Using the TriNetX global database, we retrospectively identified HCC patients undergoing LLR or RFA from 2005-2023. Propensity score matching balanced baseline characteristics, including age, comorbidities, liver function, and TNM stage. We evaluated early (1 day-1 month) overall survival (OS), as well as long-term OS and disease-free survival (DFS) in the 1-month landmark cohort (1 month-5 years). RESULTS: In the early cohort, RFA had lower short-term mortality than LLR (HR 0.501, 95% CI 0.315-0.796). From 1 month-5 years (1-month landmark cohort), RFA had higher mortality than LLR (OS HR 1.228, 95% CI 1.117-1.350) and higher DFS events (retreatment-or-death) (HR 1.823, 95% CI 1.687-1.969). CONCLUSION: In the 1-month landmark cohort, long-term OS and DFS favored LLR, whereas RFA had lower short-term mortality. These findings highlight a time-dependent trade-off and support individualized decisions balancing perioperative risk and long-term disease control. (DFS here uses retreatment-or-death as a validated proxy within TriNetX.).

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000004113