Although surgery is still recommended as the first radical measure for early-stage liver cancer, the clinical efficacy of radiofrequency ablation for early-stage liver cancer has been increasingly recognized by research studies. Moreover, radiofrequency ablation has become more and more acceptable to patients because of its low trauma, quick recovery, low complication rate and short postoperative hospital stay. According to the research papers published in international academic journals in recent years, the 1-year survival rate after radiofrequency ablation for liver cancer meeting the aforementioned indications ranges from 87% to 97.5%; the 2-year survival rate ranges from 76.5% to 91.2%; the 3-year survival rate ranges from 69.6% to 82.5%; and the 5-year survival rate ranges from 54.8% to 79.3%, respectively. Some studies have shown higher recurrence rates after radiofrequency ablation than radical surgical resection for early-stage hepatocellular carcinoma; however, most published controlled studies of radiofrequency ablation versus surgical resection for primary hepatocellular carcinoma are selectively biased. Patients enrolled in radiofrequency ablation had relatively poorer liver function reserve (including lower serum albumin, higher total bilirubin, prolonged PT, and reduced ICG-15R) than patients enrolled in radical hepatectomy for hepatocellular carcinoma. Patients who underwent radiofrequency ablation tended to have lower platelet counts, higher AST, ALT, and higher ALP (alkaline phosphatase) than patients with hepatocellular carcinoma who underwent surgical procedures. These adverse factors clearly have a significant impact on hepatocellular carcinoma patients and their survival. A study by foreign scholars using propensity score matching method compared the 1-, 2-, 3-, and 5-year survival and recurrence rates after surgical resection and radiofrequency ablation for very early-stage hepatocellular carcinoma, respectively, and did not differ statistically. Multifactorial ANOVA showed that age >65 years (HR 1.988), hypoalbuminemia (HR 1.751), total bilirubin (TBIL) >27 μmol/L (HR 2.032), PT/INR >1.1 (HR 2.114), AFP >20 ng/ml (HR 1.680), and multiple tumors (HR 1.851) were the independent risk factors for poor prognosis in hepatocellular carcinoma (HR is the relative risk)*, while surgery and RFA were not independent factors influencing the prognosis of hepatocellular carcinoma. In other words, it is not the surgical resection or radiofrequency ablation that affects the survival of patients, but the clinical characteristics of the patients with liver cancer.