Acad Radiol. 2026 Mar 9:S1076-6332(26)00117-0. doi: 10.1016/j.acra.2026.02.029. Online ahead of print.
ABSTRACT
RATIONALE AND OBJECTIVES: This retrospective study compared thermal ablation (TA) and surgical resection (SR) in treating hepatocellular carcinoma (HCC) based on multiparametric gadoxetic acid-enhanced MRI features, with an emphasis on the impact of tumor location, size, and liver function reserve.
MATERIALS AND METHODS: Patients with early-stage HCC treated with either TA or SR at our hospital from January 2016 to August 2021 were included. Propensity score matching (PSM) with a 1:1 nearest-neighbor algorithm was employed to balance nineteen predefined covariates across treatment groups. Standardized imaging protocols and blinded consensus review were implemented. Survival outcomes, including overall survival (OS) and disease-free survival (DFS), were analyzed using Kaplan-Meier curves and Cox proportional hazards regression. Subgroup analyses stratified by tumor topography, size, and albumin-bilirubin grade were performed.
RESULTS: Initially, 92 patients in the TA group and 181 patients in the SR group were included. After PSM, a balanced cohort of 50 patients in each group was achieved. No significant differences in OS (log-rank p = 0.822) or DFS (log-rank p = 0.268) were found between the TA and SR groups. The subgroup analyses after matching demonstrated no statistically significant differences in OS or DFS across the stratified groups (all p > 0.05). Further Cox analysis revealed that elevated alpha-fetoprotein (hazard ratio = 1.88, 95% CI: 1.04-3.39, p = 0.037) was an independent risk factor affecting DFS in the ablation group.
CONCLUSION: This study indicates that TA and SR offer similar therapeutic outcomes in early-stage HCC, with comparable survival outcomes for patients.
PMID:41807162 | DOI:10.1016/j.acra.2026.02.029
