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

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. 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. 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%). Resection was superior to ablation in minimizing the risk of ER and offering a better OS for patients with early HCC. •Early recurrence after local treatment is common in patients with hepatocellular carcinoma.•Ablation is associated with risk of early recurrence.•Resection is superior to ablation in reducing the risk of early recurrence.