Minimally invasive hepatectomy vs. thermoablation for single small (≤3 cm) hepatocellular carcinoma: A weighted real-life national comparison
Percutaneous thermoablation is considered an appropriate alternative to liver resection for small (≤3 cm) single hepatocellular carcinoma because of not-inferior overall survival, although several authors reported increased recurrence risk. Whether videolaparoscopic liver resection could guarantee comparable survival but superior oncologic control of the disease is a matter of debate. This study comparing videolaparoscopy <i>vs.</i> thermoablation in a large national cohort of 1,465 patients observed that the former guaranteed significant prolonged OS (93 months [95% CI 75-110] <i>vs.</i> 60 months [95% CI 52-66] for the ablation group) and recurrence-free survival (26 months [95% CI 23-29] for ablation patients and 39 months [95% CI 30-55] for laparoscopic resection patients) even after weighting all the preoperative and oncologic differences among the groups. Our results clearly address the need to rethink the role of thermoablation for single small HCC as a second-line treatment when laparoscopic liver resection is not feasible.
Authors
- Luigi Boccia
- Elisabetta Biasini (ORCID: https://orcid.org/0000-0002-6764-4703)
- Filomena Morisco (ORCID: https://orcid.org/0000-0002-9059-8311)
- Gian Luca Grazi (ORCID: https://orcid.org/0000-0002-3279-0313)
- Simone Famularo (ORCID: https://orcid.org/0000-0002-9721-6304)
- Francesco Azzaroli (ORCID: https://orcid.org/0000-0003-3675-8545)
- Francesco Giuseppe Foschi (ORCID: https://orcid.org/0000-0002-8216-0918)
- Daniele Nicolini (ORCID: https://orcid.org/0000-0002-5477-3346)
- Paola Tarchi (ORCID: https://orcid.org/0000-0002-7139-3951)
- Maurizio Iaria (ORCID: https://orcid.org/0000-0003-0778-5296)
- Luca Aldrighetti (ORCID: https://orcid.org/0000-0001-7729-2468)
- Carlo Saitta (ORCID: https://orcid.org/0000-0002-3053-4359)
- Elio Jovine
- Stefan Patauner (ORCID: https://orcid.org/0000-0001-7592-0934)
- Mario Capasso (ORCID: https://orcid.org/0009-0003-2023-5157)
- Donatella Magalotti (ORCID: https://orcid.org/0009-0002-4166-2193)
- Mohammad Abu Hilal (ORCID: https://orcid.org/0000-0002-3162-4639)
- Edoardo G. Giannini (ORCID: https://orcid.org/0000-0001-8526-837X)
- Alba Rocco (ORCID: https://orcid.org/0000-0003-0959-1807)
- Albert Troci (ORCID: https://orcid.org/0000-0002-0832-2966)
- Fabrizio Romano (ORCID: https://orcid.org/0000-0003-2918-554X)
- Umberto Cillo (ORCID: https://orcid.org/0000-0002-2310-0245)
- Gianluca Svegliati‐Baroni (ORCID: https://orcid.org/0000-0003-4399-3359)
- Alessandro Ferrero (ORCID: https://orcid.org/0000-0003-1504-5810)
- Giuseppe Cabibbo (ORCID: https://orcid.org/0000-0002-0946-3859)
- Mattia Garancini (ORCID: https://orcid.org/0000-0001-6091-4574)
- Marco Vivarelli (ORCID: https://orcid.org/0000-0001-8982-2163)
- Franco Trevisani (ORCID: https://orcid.org/0000-0002-6393-6995)
- Antonio Gasbarrini (ORCID: https://orcid.org/0000-0002-6230-1779)
- Matteo Cescon (ORCID: https://orcid.org/0000-0003-1715-3794)
- Angelo Sangiovanni (ORCID: https://orcid.org/0000-0002-9996-9385)
- Fabio Piscaglia (ORCID: https://orcid.org/0000-0001-8264-1845)
- Elton Dajti (ORCID: https://orcid.org/0000-0003-2905-1146)
- Mariano Cesare Giglio (ORCID: https://orcid.org/0000-0002-9222-5885)
- Marco Arru (ORCID: https://orcid.org/0000-0002-7112-5025)
- Alberto Masotto (ORCID: https://orcid.org/0000-0002-0496-1461)
- Paola Germani (ORCID: https://orcid.org/0000-0002-0565-0489)
- Rodolfo Sacco (ORCID: https://orcid.org/0000-0002-9887-7315)
- Luciano De Carlis (ORCID: https://orcid.org/0000-0002-9133-8220)
- Matteo Zanello (ORCID: https://orcid.org/0000-0002-5101-0968)
- Andrea Mega (ORCID: https://orcid.org/0000-0002-0458-3763)
- Michele Crespi (ORCID: https://orcid.org/0000-0002-8363-808X)
- Flavio Milana (ORCID: https://orcid.org/0000-0003-3570-9573)
- Andrea Fontana (ORCID: https://orcid.org/0000-0002-4980-374X)
- Valentina Santi (ORCID: https://orcid.org/0000-0001-7233-3654)
- Giorgia Ghittoni (ORCID: https://orcid.org/0000-0001-7898-9566)
- Davide Paolo Bernasconi (ORCID: https://orcid.org/0000-0001-8771-5428)
- Claudia Campani (ORCID: https://orcid.org/0000-0003-3842-782X)
- Michela De Angelis (ORCID: https://orcid.org/0000-0001-7759-1185)
- Federica Cipriani (ORCID: https://orcid.org/0000-0002-8651-5982)
- Riccardo Memeo
- Gianpaolo Vidili (ORCID: https://orcid.org/0000-0002-8903-5829)
- Maurizio Romano (ORCID: https://orcid.org/0000-0003-3101-7588)
- Paolo Francesco Perri (ORCID: https://orcid.org/0000-0003-4652-9842)
- Maria Stella Franzè (ORCID: https://orcid.org/0000-0002-9815-5275)
- Simone Conci (ORCID: https://orcid.org/0000-0001-7110-1974)
- Andrea Lauterio (ORCID: https://orcid.org/0000-0001-6110-8582)
- Filippo Pelizzaro (ORCID: https://orcid.org/0000-0003-0584-1442)
- Mariella Di Marco (ORCID: https://orcid.org/0000-0002-4648-3365)
- Elisa Pinto (ORCID: https://orcid.org/0000-0002-5658-942X)
- Raffaele Dalla Valle (ORCID: https://orcid.org/0000-0003-4847-6924)
- Giuseppe Zimmitti (ORCID: https://orcid.org/0000-0003-4925-4012)
- Matteo Serenari (ORCID: https://orcid.org/0000-0003-1471-8585)
- Massimo Rossi (ORCID: https://orcid.org/0000-0001-5105-4656)
- Francesco Ardito (ORCID: https://orcid.org/0000-0003-1596-2862)
- Mariarosaria Marseglia (ORCID: https://orcid.org/0000-0002-5829-4537)
- Gerardo Nardone (ORCID: https://orcid.org/0000-0001-8344-6523)
- Maria Corina Plaz Torres (ORCID: https://orcid.org/0000-0003-4257-1058)
- Fabio Marra (ORCID: https://orcid.org/0000-0001-8629-0878)
- Laura Schiadà (ORCID: https://orcid.org/0009-0002-5571-4580)
- Maurizia Rossana Brunetto (ORCID: https://orcid.org/0000-0001-8364-9152)
- Felice Giuliante (ORCID: https://orcid.org/0000-0003-2087-2589)
- Antonio Frena (ORCID: https://orcid.org/0000-0001-9461-5345)
- Guido Griseri
- Maria Conticchio (ORCID: https://orcid.org/0000-0003-3177-5274)
- Alessandro Vitale (ORCID: https://orcid.org/0000-0002-4548-8308)
- Quirino Lai (ORCID: https://orcid.org/0000-0003-1487-3235)
- Sara Grasselli
- Camilla Graziosi
- Andrea Ruzzenente
- Giacomo Zanus
- Guido Torzilli
- Roberto Troisi
- Cecilia Ferari
- Alice Saccomandi
Institutions
- Università Cattolica del Sacro Cuore (IT)
- University of Foggia (IT)
- University of Messina (IT)
- University of Verona (IT)
- Marche Polytechnic University (IT)
- University of Parma (IT)
- University of Padua (IT)
- University of Trieste (IT)
- Policlinico Umberto I (IT)
- Agostino Gemelli University Polyclinic (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Luigi Sacco Hospital (IT)
- Ospedale di Bolzano (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Azienda Ospedaliera Bolognini Seriate (IT)
- Ospedale Sacro Cuore Don Calabria (IT)
- Azienda Ospedaliero Universitaria di Sassari (IT)
- Institut de Recherche contre les Cancers de l’Appareil Digestif (FR)
- Department of Health (ES)
- University Hospitals Parma Medical Center (US)
- Ospedale San Paolo (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Federico II University Hospital (IT)
- Azienda USL di Bologna (IT)
- Ospedale per gli Infermi (IT)
- Ospedale di Belcolle (IT)
- IRCCS Ospedale San Raffaele (IT)
- Ospedale di Parma (IT)
- Ospedale Generale Regionale Francesco Miulli (IT)
- Ospedale Policlinico San Martino (IT)
- Fondazione Poliambulanza Istituto Ospedaliero (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- IRCCS Humanitas Research Hospital (IT)
- Azienda Ospedaliera Carlo Poma (IT)
- Azienda Ospedaliera Universitaria Pisana (IT)
- University of Florence (IT)
- University of Milano-Bicocca (IT)
- University of Naples Federico II (IT)
- University of Genoa (IT)
- Sapienza University of Rome (IT)
- University of Bologna (IT)
Publication Details
- Journal
- JHEP Reports
- Published
- 2025-04-25
- DOI
- https://doi.org/10.1016/j.jhepr.2025.101420
- Citations
- 4
- Primary Topic
- Hepatocellular Carcinoma Treatment and Prognosis
- Type
- article
- Field-Weighted Citation Impact
- 5.29
Funders
- Ministero della Salute