An explorative data-analysis to support the choice between hepatic resection and radiofrequency ablation in the treatment of hepatocellular carcinoma.

Abstract Background Whether to prefer hepatic resection or radiofrequency ablation as first line therapy for hepatocellular carcinoma is a matter of debate. Aims To compare outcomes of resection and ablation, in the treatment of early hepatocellular carcinoma, through a decision-making analysis. Methods Data of 388 cirrhotic patients undergoing resection and of 207 undergoing radiofrequency ablation were reviewed. Two distinct regression models were devised and used to perform sensitivity and probabilistic analyses, to overcome biases of covariate distributions. Results Actuarial survival curves showed no difference between resection and ablation ( P  = 0.270) despite the fact that ablated patients were older, with worse liver function and smaller, unifocal tumours ( P Conclusions The superiority, or the equivalence, of resection and ablation depends on the non-linear relationship existing between treatment, tumour number, size and degree of liver dysfunction.