Efficacy of radiofrequency ablation of hepatocellular carcinoma prior to liver transplantation and the need for competing-risk analysis

Radiofrequency ablation (RFA) currently represents a potentially curative treatment for hepatocellular carcinoma (HCC) in its early stages (1,2). Providing higher rates of complete necrosis of target tumor than other loco-regional therapies (LRTs), RFA plays an important role as bridge therapy to liver transplantation (LT) (3). In the study from Lee and colleagues of the UCLA medical center, published in issue of June 2017 of Hepatology, Authors analyzed the outcome of 121 patients with 156 de-novo HCC treated with RFA as initial stand-alone therapy (4). The study is a fair attempt to analyze the efficacy of RFA as bridge therapy to LT, considering all potential outcome measures. Nevertheless, some results passed unnoticed, while instead deserve further discussion.