Liver Transplant After Successful Thermal Ablation Shows No Significant Survival Gain in Older Adults with Early HCC

In adults aged 60–80 with early-stage HCC (BCLC 0/A) and Child-Pugh A cirrhosis who achieved complete ablation response, adding liver transplant conferred no statistically significant OS or cancer-specific survival advantage over surveillance alone (5-yr OS 92% vs 81%, p=0.075;…

• Retrospective single-cohort study of 98 patients (2011–2020); groups stratified by whether OLT followed complete percutaneous thermal ablation at 6 months.
• Intention-to-treat analysis mirrored per-protocol results: 5-yr OS 85.1% (waitlisted) vs 83.5% (not waitlisted), p=0.76; time-varying Cox regression also showed no significant transplant-associated OS benefit (p=0.24).
• Key limitation: small retrospective cohort with inherent selection bias — patients who proceeded to OLT may differ systematically from those managed with surveillance, limiting causal inference; not externally validated.

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