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Updated: Jan 5, 2026
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Surgery versus external beam radiation therapy for AJCC stage I hepatocellular carcinoma
Bing Han1, Lichun Shao, Chuan Li
1Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China.
Purpose:
To compare the survival of American Joint Committee on Cancer (AJCC) stage I hepatocellular carcinoma (HCC) treated with surgery versus external beam radiation therapy (EBRT).
Methods:
Surveillance, Epidemiology, and End Results (SEER) database was used to identify the patients diagnosed with HCC between 2004 and 2013. Overall survival (OS) and liver-specific survival (LSS) were compared between patients treated with surgery and EBRT. A 1:1 propensity score matching (PSM) analysis was employed by matching age, sex, and race.
Results:
Among the 1553 patients with HCC ≤2cm, there was no significant difference in OS (p=0.605, before PSM; p=0.891, after PSM) and LSS (p=0.281, before PSM; p=0.346, after PSM) between patients treated with surgery and EBRT. Among the 1752 patients with HCC >2cm and ≤3cm, patients treated with surgery had significantly better OS (p=0.001) than those treated with EBRT, but statistically similar LSS (p=0.072) before PSM; however, there was no significant difference in OS (p=0.139) and LSS (p=0.722) between patients treated with surgery and EBRT after PSM. Additionally, 1157, 723, and 1331 patients had HCC >3cm and ≤4cm, HCC >4cm and ≤5cm, and HCC >5cm, respectively; among them, patients treated with surgery had significantly better OS and LSS than those treated with EBRT regardless of PSM.
Conclusions:
At the AJCC stage I, the survival after EBRT might be comparable to that after surgery for HCC ≤3cm, but the survival after EBRT was inferior to that after surgery for HCC >3cm.
