ArticleWorld journal of surgical oncology2025
Therapeutic efficacy of hepatic resection versus radiofrequency ablation for recurrent hepatocellular carcinoma within Milan criteria: a propensity score matching study.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatic resection(HR) and radiofrequency ablation(RFA) are widely used for recurrent hepatocellular carcinoma(RHCC), yet their therapeutic efficacy remains debated. This study aimed to compare outcomes of HR versus RFA in RHCC patients within Milan Criteria.
methodsThis was a retrospective single-center study of patients with HCC recurrence after initial radical hepatectomy for primary liver cancer, meeting Milan criteria for recurrence. Patients underwent HR (n = 128) or RFA (n = 134) at West China Hospital of Sichuan University between January 2015 and August 2019. The final follow-up date for this study was August 31, 2022. Propensity score matching (1:1 ratio) was applied to balance baseline characteristics. Clinical outcomes were analyzed before and after matching.
resultsBefore matching, the hepatic resection group demonstrated significantly higher 1-, 3-, and 5-year recurrence-free survival rates compared to the radiofrequency ablation group (67.2%, 41.7%, 31.3% vs. 55.2%, 26.5%, 17.3%; P = 0.007), but overall survival showed no significant difference (99.2%, 80.0%, 63.9% vs. 94.2%, 72.6%, 42.4%; P = 0.064). After matching, recurrence-free survival remained higher in the hepatic resection group (71.5%, 44.9%, 36.1% vs. 57.8%, 29.9%, 17.0%; P = 0.013), while overall survival differences remained nonsignificant (97.8%, 78.1%, 58.5% vs. 91.5%, 74.9%, 42.6%; P = 0.203). Hepatic resection was associated with higher hospitalization costs, blood loss, longer hospital stays, and more complications (all P < 0.001). Subgroup analysis revealed no significant differences in recurrence-free or overall survival when the recurrence interval was ≤ 24 months. Multivariate analysis identified recurrence interval ≤ 24 months and radiofrequency ablation as independent risk factors for tumor recurrence, while recurrence interval ≤ 24 months or preoperative alpha-fetoprotein > 200 ng/ml were risk factors affecting overall survival.
conclusionFor recurrent hepatocellular carcinoma within Milan Criteria, while hepatic resection improved recurrence-free survival, overall survival did not differ significantly between resection and RFA. RFA may be considered for selected high-risk surgical patients, acknowledging its higher recurrence potential.
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