Table 2.
Summary of treatment modality in small hepatocellular carcinoma (HCC)
| Study design | Compare with study population | Inclusion creteria | Survival outcome | Other outcome | Preference | |
|---|---|---|---|---|---|---|
| Chen et al. [1] | RCT | RFA (n=71) vs. HR (n=90) | Solitary ≤5 cm | No difference | More complication at HR | Prefer RFA to HR |
| Huang et al. [6] | RCT | RFA (n=115) vs. HR (n=115) | Within Milan criteria | Better survival, lower recurrence in HR | Better survival in HR for <3 cm as well as <5 cm | Prefer HR to RFA |
| Feng et al. [7] | RCT | RFA (n=84) vs. HR (n=84) | HCC ≤4 cm | No difference | Multiple tumor and high ICGR15 are poor risk factors | Prefer HR to RFA |
| Up to 2 masses | ||||||
| Hasegawa et al. [3] | Retrospective Nationwide cohort | RFA (n=5,548) vs. HR (n=5,361) vs. PEI (n=2,059) | No more than 3 tumors and each tumor less than 3 cm | Better DFS and OS in HR group than RFA and PEI group | RFA has better survival outcome than that of PEI | HR>RFA>PEI |
| Fang et al. [8] | RCT | RFA (n=60) vs. HR (n=60) | Solitary ≤3 cm | No difference | Lower complication in RFA | Prefer RFA |
| Huang et al. [2] | Non randomaized prospective | RFA (n=121) vs. HR (n=225) | Solitary ≤3 cm | No difference | Better outcome of life quality in RFA | Prefer RFA to HR |
| Imai et al. [9] | Retrospective | RFA (n=82) vs. HR (n=101) | Solitary ≤3 cm | Better OS and DFS in HR for <3 cm | No difference in ≤2 cm | Prefer HR in larger than 2 cm |
| Better disease free and overall survival in larger than 2 cm | ||||||
| Kim et al. [5] | Case control | RFA (n=152) vs. HR (n=152) | Solitary ≤3 cm | Better DFS in HR than RFA, no different OS | Higher risk of treatment site recurrence in RFA | HR is prefer to RFA |
| Kutlu et al. [4] | Retrospective | RFA (n=437) vs. HR (n=671) vs. LT (n=786) | Solitary ≤5 cm | Less than 3 cm: RFA=HR<lt | Better survival in HR than RFA for 3.1–3.5 cm | RFA is not desirable in tumor larger than 3 cm |
| Between 3 and 5 cm: RFA<hr<lt | ||||||
| Ng et al. [10] | RCT | RFA (n=109) vs. HR (n=109) | Milan criteria | Marginally better DFS in HR (P=0.072), no difference in OS | - | Prefer HR to RFA |
RCT, randomized controlled trial; RFA, radiofrequency ablation; HR, hepatic resection; ICGR15, indocyanine green retension rate at 15 min; PEI, percutaneous ethanol injection; DFS, disease-free survival; OS, overall survival; LT, liver transplantation.