Yee-Hui YeoYi-No KangChiehfeng ChenTeng-Yu LeeChun-Chieh YehTsai-Wei HuangChun-Ying Wu2026-02-042026-02-042024-07-1710.1097/JS9.0000000000001943https://scholars.csmu.edu.tw/handle/123456789/5110<jats:sec> <jats:title>Background:</jats:title> <jats:p>Liver resection (LR) and radiofrequency ablation (RFA) are the most commonly used treatment modalities for early-stage hepatocellular carcinoma (ES-HCC). The comparative efficacy of LR and RFA in ES-HCC remains debated. The authors conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>The authors searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing RFA and LR interventions for the treatment of ES-HCC. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The authors used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Our meta-analysis included nine RCTs with a total of 1516 HCC patients. Compared with patients receiving RFA, those receiving LR did not have significantly different 2-year OS (HR=1.28, 95% CI: 0.73–2.23) and 5-year OS (HR=1.49, 95% CI: 0.99–2.24). However, patients receiving LR showed a favorable trend in 2-year DFS (HR=1.40, 95% CI: 1.16–1.69) and 5-year DFS (HR=1.37; 95% CI: 1.05–1.77), although these results are not conclusive due to underpowered significance. The heterogeneity was low, and the outcomes were statistically reliable.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion:</jats:title> <jats:p>Meta-analysis suggests that while LR shows a favorable trend in DFS compared to RFA for ES-HCC, the present evidence does not thoroughly support recommending LR over RFA. The inconclusive nature of these findings highlights the need for further large-scale RCTs to establish definitive comparative efficacy.</jats:p> </jats:sec>journal-article