Multicenter retrospective cohort study of liver resection versus nonsurgical treatments for early multinodular hepatocellular carcinoma

The 2022 Barcelona Clinic Liver Cancer algorithm currently discourages liver resection (LR) for patients with multinodular hepatocellular carcinoma. A multicenter retrospective cohort study in Italy compared LR versus percutaneous radiofrequency ablation (PRFA) or transarterial chemoembolization (TACE). A matching-adjusted indirect comparison method (MAIC) was applied to balance data. After MAIC, LR exhibited 1- and 5-year survival rates of 89% and 56%, while PRFA showed rates of 94% and 40%, and TACE displayed rates of 91% and 29%, respectively. Competing risk analysis confirmed a lower risk of cancer-related death in LR compared with PRFA and TACE. The authors conclude that LR should be considered the first therapeutic option in patients with early multinodular HCC who are not eligible for transplant.