Early recurrence of hepatocellular carcinoma in patients after ablation and resection: A propensity score analysis

Background: Early recurrence (ER, recurrence within 2 years) is common in hepatocellular carcinoma (HCC) patients after ablation and resection. We aimed to compare ER and assess the associated risk factors. Methods: We collected data from patients underwent resection (1,235) or ablation (517) for early HCC (solitary tumor <5 cm). Baseline of patients were matched using propensity score matching. Results: In the matched cohort of 690 patients, the ablation group had a higher ER rate (37.4% vs. 19.4%; P < .001) than the resection group. Patients with ER had worse overall survival (OS) than those without ER in both the ablation (5-year OS: 60.4% vs. 86.7%) and resection groups (5-year OS: 59.2% vs. 88.1%). Ablation treatment was identified as an independent adverse prognostic factor for ER (hazard ratio: 2.751, P < .001). Resection conferred a significant favorable OS than ablation (2-year: 95.4% vs. 90.9%; 5-years: 83.8% vs. 77.0%). Conclusions: Resection was superior to ablation in minimizing the risk of ER and offering a better OS for patients with early HCC.