Introduction : Laparoscopic liver resection (LLR) is rapidly increasing procedure, and certain types of resection are considered standard procedures for liver resection, especially for small hepatocellular carcinoma (HCC) located on the anterolateral segments of the liver. However, there have been few reports with a focus on comparing two minimal invasive treatment including LLR and radiofrequency ablation (RFA) for HCC.

Methods : We retrospectively compared short- and long-term outcomes of 105 patients with LLR and 272 patients with RFA for newly diagnosed single, less than 4cm size of HCC located on the anterolateral segments of the liver. We performed 1:1 propensity score matching (PSM) between two groups and matched 61 patients for both groups.

Results : After PSM, all variables including demographic, tumor factors and liver function were similar between two groups. The hospital stay was significantly shorter in RFA group compared with LLR group (5.1 days vs. 8.9 days. p=0.001). There was no case of treatment related mortality in the two group. On the other hands, there was no significant difference in treatment related complications (p=0.114). There was no significant difference in overall survival rates between the two groups (00 % vs. 00%; p=0.913). However, the 3- and 5- year disease-free survival rates were higher in LLR group (67.5% and 56.4%) than RFA (47.9% and 41.8%; p=0.009). The rate of local recurrence was 4.0 % and 22.5% in LLR and RFA group, respectively (p=0.044).

Conclusions : For single small HCC, LLR showed similar complications and overall survival rates, however better disease-free survival rate compared to RFA.