Survival Outcome Was Better with Liver Resection than with Percutaneous Radiofrequency Ablation in Patients with Very Early-Stage Hepatocellular Carcinoma: A Single-Center Retrospective Study.

[BACKGROUND] Antiviral therapies for hepatitis B or C virus may be associated with reduced risk of tumor recurrence and mortality of patients with hepatocellular carcinoma (HCC) undergoing curative treatments, compared to untreated patients. Previous studies comparing survival outcomes between percutaneous radiofrequency ablation (RFA) and liver resection (LR) for treating patients with very early-stage HCC did not evaluate the effects of antiviral treatments on survival outcome. Our study aimed to clarify this issue.

[METHODS] From 2011 to 2021, 265 patients undergoing LR and 269 patients undergoing RFA for very early-stage HCC (i.e., a single tumor ≤2 cm without macrovascular invasion or extrahepatic metastasis, with Eastern Cooperative Oncology Group performance status = 0 and Child-Pugh class A liver disease) were included in this retrospective study. Survival analysis was performed using the Kaplan - Meier method after propensity score matching (PSM).

[RESULTS] After 1:1 PSM ( = 205 in both groups), the survival benefit of LR was significantly higher than that of RFA (five-year OS: 85% vs. 73%;  = 0.004; five-year RFS: 64% vs. 45%;  < 0.001).

[CONCLUSIONS] For patients with very early-stage HCC, LR was associated with superior OS and RFS compared to RFA.