Publication Name	World Journal of Gastroenterology
Manuscript ID	116653
Country	Italy

Category	Oncology
Manuscript Type	Editorial
Article Title	Small tumors, big decisions: Rethinking resection and ablation in early hepatocellular carcinoma
Manuscript Source	Invited Manuscript
All Author List	Marcello Maestri and Ottavia Cicerone
Funding Agency and Grant Number
Corresponding Author	Marcello Maestri, MD, PhD, Professor, General Surgery Unit I - Liver Service, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia 27100, Italy. m.maestri@smatteo.pv.it
Key Words	Hepatocellular carcinoma; Liver resection; Radiofrequency ablation; Therapeutic hierarchy; Barcelona Clinic Liver Cancer; Local ablation
Core Tip	Early hepatocellular carcinoma is typically managed with resection or local ablation, yet growing evidence shows that resection provides superior long-term oncologic outcomes whenever feasible. Modern ablative technologies, no-touch radiofrequency ablation, microwave ablation, and fusion-imaging guidance, have improved local control but do not surpass the curative potential of anatomical resection. The limitations of the Barcelona Clinic Liver Cancer staging system highlight the need for individualized decision-making. The therapeutic hierarchy, ranking treatments by intrinsic curative power, offers a dynamic, patient-centered framework better aligned with contemporary practice. Selecting the highest feasible therapy for each patient ensures the best outcomes in early-stage hepatocellular carcinoma.
Citation	Maestri M, Cicerone O. Small tumors, big decisions: Rethinking resection and ablation in early hepatocellular carcinoma. World J Gastroenterol 2026; In press

Received	2025-11-17 02:33
Peer-Review Started	2025-11-17 02:33
First Decision by Editorial Office Director	2025-12-30 07:37
Return for Revision	2025-12-30 07:37
Revised	2025-12-30 09:48
Publication Fee Transferred
Second Decision by Editor	2026-01-29 02:33
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-01-29 07:20
Articles in Press	2026-01-29 07:20
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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