No-touch multibipolar radiofrequency ablation (NTM-RFA) represents a novel therapy that surpasses standard RFA for hepatocellular carcinoma (HCC), but it has not been compared to surgical resection (SR). We aimed to compare the outcomes of NTM-RFA and SR for intermediate-sized HCC. Between 2012 and 2016, 141 patients with solitary HCC ranging from 2 to 5 cm were treated by NTM-RFA or SR at a single-center. The outcomes of 128 patients were compared after using inverse probability of treatment weighting (IPTW). Seventy-nine patients had NTM-RFA and 62 had SR. After IPTW, the two groups were well-balanced for most baseline characteristics including tumor size, location, etiology, severity of underlying liver disease and alpha-fetoprotein level. Morbidity was higher (67.9% 50.0%, = 0.042) and hospital stay was longer (12 [IQR 8–13] 7 [IQR 5–9] days, <0.001) after SR. Local recurrence rates at one and three years were 5.5% and 10.0% after NTM-RFA and 1.9% and 1.9% after SR, respectively ( = 0.065). The rates of systematized recurrence (within the treated segment or in an adjacent segment within a 2 cm distance from treatment site) were higher after NTM-RFA (7.4% 1.9% at one year, 27.8% 3.3% at three years, = 0.008). Most patients with recurrence were eligible for rescue treatment, resulting in similar overall survival (86.7% after NTM-RFA, 91.4% after SR at three years, = 0.954) and disease-free survival (40.8% after NTM-RFA, 56.4% after SR at three years, = 0.119). Compared to SR, NTM-RFA for solitary intermediate-sized HCC was associated with less morbidity and more systematized recurrence, while the rate of local recurrence was not significantly different. Most patients with intrahepatic recurrence remained eligible for rescue therapies, resulting in equivalent long-term oncological results after both treatments. Outcomes of patients treated for intermediate-sized hepatocellular carcinoma by surgical resection or no-touch multibipolar radiofrequency ablation were compared. No-touch multibipolar radiofrequency ablation was associated with a lower overall morbidity and a higher rate of systematized recurrence within the treated segment or in an adjacent segment within a 2 cm distance from the initial tumor site. Most patients with intrahepatic recurrence remained eligible for rescue curative therapy, enabling them to achieve similar long-term oncological results after both treatments.

中文翻译：

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非接触式多极射频消融与手术切除治疗 2 至 5 cm 的孤立性肝细胞癌

无接触多双极射频消融 (NTM-RFA) 是一种优于肝细胞癌 (HCC) 标准 RFA 的新型疗法，但尚未与手术切除 (SR) 进行比较。我们的目的是比较 NTM-RFA 和 SR 对于中等大小 HCC 的结果。 2012年至2016年间，141名2至5cm的孤立性HCC患者在单中心接受了NTM-RFA或SR治疗。使用治疗加权逆概率 (IPTW) 比较 128 名患者的结果。 79 名患者接受 NTM-RFA，62 名患者接受 SR。 IPTW 后，两组的大多数基线特征均达到良好平衡，包括肿瘤大小、位置、病因、潜在肝病的严重程度和甲胎蛋白水平。 SR 后发病率更高 (67.9% 50.0%, = 0.042)，住院时间更长 (12 [IQR 8–13] 7 [IQR 5–9] 天，<0.001)。 NTM-RFA 后一年和三年的局部复发率分别为 5.5% 和 10.0%，SR 后 1.9% 和 1.9% (= 0.065)。 NTM-RFA 后系统化复发率（在治疗节段内或距治疗部位 2 cm 距离内的相邻节段）较高（一年时 7.4% 1.9%，三年时 27.8% 3.3%，= 0.008） 。大多数复发患者有资格接受抢救治疗，从而获得相似的总生存率（NTM-RFA 后 86.7%，三年后 SR 后 91.4%，= 0.954）和无病生存率（NTM-RFA 后 40.8%，SR 后 56.4%）。三年时的 SR = 0.119）。与 SR 相比，NTM-RFA 治疗孤立性中等大小 HCC 的发病率较低，复发率更高，但局部复发率没有显着差异。大多数肝内复发患者仍然有资格接受挽救治疗，两种治疗后的长期肿瘤学结果相当。比较了通过手术切除或非接触式多极射频消融治疗中等大小肝细胞癌的患者的结果。非接触式多双极射频消融与治疗节段内或距初始肿瘤部位 2 cm 距离内的相邻节段内较低的总体发病率和较高的系统化复发率相关。大多数肝内复发患者仍然有资格接受挽救性治疗，使他们在两种治疗后都能获得相似的长期肿瘤学结果。