摘要Background:About 10％-20％of all individuals who develop hepatocellular carcinoma(HCC)do not have cirrhosis.Comparisons are rarely reported regarding the effectiveness of radiofrequency ablation(RFA)and liver resection(LR)in survival of HCC without cirrhosis and stratification by tumor size ≤ 5 cm.Methods:We used the Surveillance,Epidemiology,and End Results(SEER)database and identified 1505 patients with a solitary HCC tumor ≤ 5 cm who underwent RFA or LR during 2004-2015.Patients were classified into non-cirrhosis and cirrhosis groups and each group was categorized into three subgroups,according to tumor size(≤ 30 mm,31-40 mm,41-50 mm).Results:In patients without cirrhosis,LR showed better 5-year HCC cancer-specific survival than RFA in all tumor size subgroups(≤ 30 mm:82.51％vs.56.42％;31-40 mm:71.31％vs.46.83％;41-50 mm:74.7％vs.37.5％;all P＜0.05).Compared with RFA,LR was an independent protective factor for HCC cancer-specific survival in multivariate Cox analysis[≤ 30 mm:hazard ratio(HR)=0.533,95％confidence interval(CI):0.313-0.908;31-40 mm:HR=0.439,95％CI:0.201-0.957;41-50 mm:HR=0.382;95％CI:0.159-0.916;all P＜0.05].In patients with cirrhosis,for both tumor size ≤ 30 mm and 31-40 mm groups,there were no significant survival differences between RFA and LR in multivariate analysis(all P＞0.05).However,in those with tumor size 41-50 mm,LR showed significantly better 5-year HCC cancer-specific survival than RFA in both univariate(54.72％vs.23.06％;P＜0.001)and multivariate analyses(HR=0.297;95％CI:0.136-0.648;P=0.002).Conclusions:RFA is an inferior treatment option to LR for patients without cirrhosis who have a solitary HCC tumor ≤ 5 cm.