Dear Editor,
Thank you for comments on our article. Li et al. [1] claimed that precision of the PSM analysis was not mentioned. As we wrote in Result, we matched background of the TACE group and the RFA group with 7 factors and c-index of the propensity score lowered from 0.72 to 0.48 by the matching. Consequently, the average scores in the TACE group and the RFA group after PSM became very close (0.342 and 0.356, respectively). Although we could not adjust hidden biases, no difference of the 7 factors between the 2 groups was observed after PSM.
Recently, several molecular target agents (MTAs) have been developed, and they are selected as recommended therapies for intermediate HCC in some treatment guidelines of HCC [2, 3]. Main target of MTAs in the guidelines was the tumors beyond up-to-7 criteria or TACE refractory cases. Whereas the advantage of TACE with sorafenib for preventing recurrence was reported [4]; however, it is not a standard therapy and survival benefit of the therapy has not been proven, yet. What we demonstrated is the benefit of RFA for the treatment of intermediate HCC mainly within up-to-7 criteria. Later, use of MTAs is another problem, and the evolution of MTAs will make the interpretation of many published studies about the treatment of HCC more difficult.
Conflict of Interest Statement
Kazuhiro Nouso is an Editorial Board Member of Liver Cancer. Kazuya Kariyama has no conflict of interest related to this study.
Funding Sources
This research received no external funding.
Author Contributions
K.N.: drafting of manuscript; K.K.: finalization of manuscript.
References
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