Gao YM, Tang SK, Luo ZW, Zhi WH, Yan X, Yin X, Bi XY, Han Y. Long-term outcomes of thermal ablation vs surgical resection for single small hepatocellular carcinoma. World J Clin Oncol 2025; 16(11): 112212 [DOI: 10.5306/wjco.v16.i11.112212]
Corresponding Author of This Article
Yue Han, MD, PhD, Professor, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan 3rd Alley, Dongcheng District, Beijing 100021, China. doctorhan@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 24, 2025 (publication date) through Nov 21, 2025
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Journal Information of This Article
Publication Name
World Journal of Clinical Oncology
ISSN
2218-4333
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Gao YM, Tang SK, Luo ZW, Zhi WH, Yan X, Yin X, Bi XY, Han Y. Long-term outcomes of thermal ablation vs surgical resection for single small hepatocellular carcinoma. World J Clin Oncol 2025; 16(11): 112212 [DOI: 10.5306/wjco.v16.i11.112212]
Ying-Ming Gao, Sai-Kang Tang, Wei-Hua Zhi, Yue Han, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhi-Wen Luo, Xin Yin, Xin-Yu Bi, Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Xue Yan, Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China
Author contributions: Gao YM conducted formal analysis, software, validation, and wrote the original draft and prepared visualizations; Gao YM, Tang SK, Luo ZW, Zhi WH, Yan X, and Yin X contributed to investigation; Gao YM and Luo ZW contributed to data curation; Luo ZW and Han Y contributed to methodology; Bi XY and Han Y provided resources and contributed to review and editing; Han Y conceptualized and supervised the study, provided resources and project administration. All authors have read and approved the final manuscript.
Institutional review board statement: This study has been reviewed and approved by the Medical Ethics Committee of the Cancer Hospital of the Chinese Academy of Medical Sciences (approval No. 25/017-4963). The authors declare that there are no ethical or legal conflicts related to the content of this article.
Informed consent statement: The requirement for informed consent was waived by the Medical Ethics Committee of the Cancer Hospital of the Chinese Academy of Medical Sciences.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Due to patient privacy regulations and institutional policies, the datasets are not publicly available. However, anonymized data may be made available upon reasonable request to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue Han, MD, PhD, Professor, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan 3rd Alley, Dongcheng District, Beijing 100021, China. doctorhan@163.com
Received: July 24, 2025 Revised: August 27, 2025 Accepted: October 27, 2025 Published online: November 24, 2025 Processing time: 120 Days and 12.2 Hours
Abstract
BACKGROUND
Thermal ablation (TA), including radiofrequency ablation and microwave ablation, is a commonly used curative treatment for single small hepatocellular carcinoma (sHCC). The relative advantages of TA and surgical resection (SR) in terms of long-term survival remain controversial.
AIM
To compare their long-term efficacy in this patient population.
METHODS
This population-based retrospective cohort study included 257 patients who received a first diagnosis of single sHCC and underwent SR or TA from January 2012 to September 2017. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS).
RESULTS
The average follow-up duration was 11.4 years. The 1-, 3-, 5-, and 10-year OS rates were 95.8%, 86.0%, 82.5%, and 74.2% in the SR group vs 97.4%, 85.8%, 78.6%, and 65.6% in the TA group, with the median OS not yet reached. The 1-, 3-, 5-, and 10-year RFS rates were 79.8%, 59.6%, 46.2%, and 24.7% in the SR group vs 83.9%, 61.5%, 47.9%, and 41.2% in the TA group, with median RFS values of 3.95 and 4.63 years, respectively. No significant differences in OS or RFS were observed overall (OS: P = 0.244; RFS: P = 0.180), but in patients ≤ 60 years, TA led to a higher RFS than SR (P = 0.021). Multivariate analysis identified age, tumor differentiation grade, and Child-Pugh classification as independent risk factors for OS, whereas age and differentiation grade were significant risk factors for RFS.
CONCLUSION
In patients with single sHCC, SR, and TA offered comparable long-term efficacy. However, TA showed superior RFS in patients ≤ 60 years, suggesting that TA may be a reasonable option for younger patients, pending confirmation by prospective studies.
Core Tip: This study evaluated the long-term outcomes of patients with single small hepatocellular carcinoma treated with thermal ablation (TA) or surgical resection. Overall, TA and surgical resection achieved comparable long-term outcomes; however, among patients aged 60 years or younger, TA was associated with better recurrence-free survival. This suggests that for younger patients seeking less invasiveness and faster recovery, TA is not merely an alternative - it may offer an advantage in reducing recurrence. Treatment decisions should still integrate tumor differentiation, liver function, and the experience of the clinical team.
