Reply to the Letter to the Editor: “Radiofrequency ablation versus repeat resection for recurrent hepatocellular carcinoma (≤ 5 cm) after initial curative resection”

by Yuemin Feng, Qiang Zhu (zhuqiang@sdu.edu.cn)

Radiofrequency ablation versus repeat resection for recurrent hepatocellular carcinoma (≤ 5 cm) after initial curative resection

Dear Editor,

We appreciate the interest in our manuscript which compared radiofrequency ablation versus repeat resection for recurrent hepatocellular carcinoma after initial curative resection [1].

The letter from Dr. Han et al. regarding our study raised two questions. Firstly, Dr. Han and his colleagues indicated that the precision of the PSM analysis was not mentioned in our manuscript. In fact, we provided the precision of the PSM analysis in the “Propensity score matching” section in our paper. In this study, we performed a 1:1 propensity score matching (PSM) using the caliper of 0.1.

Secondly, Dr. Han noted the effects of immune-targeted drugs (such as sorafenib) on the recurrent HCC after radiofrequency ablation or repeat resection. According to recent HCC guidelines, immune-targeted drugs are not recommended for patients after curative treatment of primary HCC [2, 3]. At the same time, there is no consensus on whether recurrent HCC patients should be treated with immune-targeted drugs after repeat resection or RFA. In our retrospective study, four (2.0%) patients in RFA group and one (1.1%) patient in repeat resection group took the immune-targeted drugs. There was no significant difference between the two groups in the proportion of patients who have taken immune-targeted drugs (p = 0.947). The main purpose of our study was comparing the efficacy and safety of RFA and repeat resection in recurrent HCC. Future research will be required to determine the effect of immune-targeted treatment on re-recurrence of HCC and hepatic function for recurrent HCC patients after curative treatment.