The optimal treatment approach in very-early and early-stage hepatocellular carcinoma (HCC) is not precisely defined, and there is ambiguity in the literature around the comparative efficacy of surgical resection versus ablation as curative therapies for limited disease. We performed this real-world propensity-matched, multi-centre cohort study to assess for differences in survival outcomes between those undergoing resection and those receiving ablation. Patients with Barcelona Clinic Liver Cancer (BCLC) 0/A HCC first diagnosed between 1 January 2016 and 31 December 2020 who received ablation or resection as initial treatment were included in the study. A total of 450 patients were included in the study from 10 major liver centres including two transplant centres. Following propensity score matching using key covariates, 156 patients were available for analysis with 78 in each group. Patients who underwent resection had significantly improved overall survival (log-rank testp= 0.023) and local recurrence-free survival (log rank testp= 0.027) compared to those who received ablation. Based on real-world data, our study supports the use of surgical resection in preference to ablation as first-line curative therapy in appropriately selected BCLC 0/A HCC patients.
对于极早期和早期肝细胞癌（HCC）的最佳治疗方案尚未明确界定，现有文献中关于手术切除与消融作为局限性病灶根治性疗法的疗效比较仍存在争议。本研究通过一项真实世界倾向性匹配的多中心队列研究，评估接受切除术与消融术患者在生存结局方面的差异。研究纳入2016年1月1日至2020年12月31日期间首次确诊、接受消融或切除作为初始治疗的巴塞罗那临床肝癌分期（BCLC）0/A期HCC患者。研究共纳入来自10个主要肝脏中心（含2个移植中心）的450例患者。经关键协变量倾向评分匹配后，最终156例患者纳入分析，每组各78例。与接受消融治疗的患者相比，接受切除术的患者总生存期（对数秩检验p=0.023）和局部无复发生存期（对数秩检验p=0.027）均显著改善。基于真实世界数据，本研究支持在经恰当选择的BCLC 0/A期HCC患者中，将手术切除作为优于消融的一线根治性治疗方案。
肿瘤(癌症)患者之家