Shall we take a second thought before applying radiofrequency ablation for resectable HCC ≤2 cm?

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally.
• Early-stage HCC treatment options include resection and radiofrequency ablation (RFA).
• Current research suggests RFA may be preferred even for resectable tumors.

Purpose of the Study:

• To compare the surgical outcomes of anatomic resection versus RFA for small HCC (≤2 cm).
• To evaluate survival benefits of different treatment modalities in early HCC.
• To identify factors influencing treatment choice for resectable HCC.

Main Methods:

• Retrospective analysis of surgical outcomes for HCC patients.
• Comparison of survival rates between anatomic resection and RFA groups.
• Assessment of tumor characteristics like satellite lesions and microvascular invasion.

Main Results:

• Anatomic resection demonstrated superior survival rates compared to RFA in patients with well-preserved liver function and no cirrhosis.
• Early-stage HCC (≤2 cm) can present with satellite lesions and microvascular invasion, favoring resection.
• The benefits of anatomic resection, such as complete tumor removal, are not replicable by ablation.

Conclusions:

• Anatomic resection may be the preferred treatment for resectable HCC (≤2 cm) in patients without liver cirrhosis.
• Further large-scale randomized controlled trials (RCTs) are needed to definitively establish the optimal treatment strategy.
• Understanding tumor biology and patient factors is crucial for selecting the best HCC treatment.