Lim C, et al. - The physicians aimed to investigate the impact of time-to-surgery (TTS) in the outcome of patients with liver resection for the Barcelona Clinic Liver Cancer (BCLC) 0-A stage hepatocellular carcinoma (HCC). Without impaired oncologic outcomes, patients with BCLC stage 0-A single HCC could undergo surgery with TTS ≥ 3 months. In the TTS, an increase within a safe range could allow time for proper evaluation before surgery, and ethical testing of new neoadjuvant treatments aiming to reduce the high rate of tumor recurrence despite curative resection.

• The physicians studied all patients resected for BCLC stage 0-A single HCC from 2006 to 2016 to assess the effect of TTS on recurrence rate, recurrence-free survival (RFS), transplantability following recurrence, and intention-to-treat overall survival (ITT-OS).
• Further, they performed propensity score matching (PSM) to ensure comparability.

• A total of 100 patients were included.
• After diagnosis, surgery was performed between 0.6 and 77 months (median TTS: 3 months; interquartile range: 1.8 - 4.6 months).
• The physicians observed no post-operative mortality.
• Patients with TTS ≥ 3 months (70% of these patients had TTS 3-6 months) than those with TTS < 3 months had a higher post-operative morbidity (36% vs. 16%, p = 0.02), a similar tumor recurrence rate (32% vs. 32%, p = 1.00), RFS (37% vs. 48%, p = 0.42), transplantability following tumor recurrence (63% vs. 50% p = 0.48), and 5-year ITT-OS (82% vs. 80%, p = 0.20).
• After PSM, similar results were observed.