We thank Okumura et al. for their interest in our paper [
1], which compared the long-term outcomes of surgical resection (SR) with those of proton beam therapy (PBT) for operable hepatocellular carcinoma (HCC). The results of our study suggested that SR might be better than PBT as an initial treatment for HCC in patients with good liver function and performance status (PS). In contrast, PBT should be considered the best option for patients with a poor PS based on our post-propensity score-matching (PSM) analysis, as the advantage of SR disappeared when there was no significant difference in the PS. …