Introduction: A switching monopolar no-touch radiofrequency ablation (RFA) technique is used for small hepatocellular carcinoma (HCC); however, there have not been any randomized clinical trials comparing this technique to the conventional RFA technique. Objective:This study aims to compare the results of two RFA techniques, and to comparatively identify more effective methods to reduce the progression of local tumors associated with small HCC (≤2.5 cm). Methods: This prospective randomized clinical trial (NCT03375281) recruited a total of 116 participants (M:F, 93:23; 68.3 ± 8.4 years) between October 2016 and September 2017. The primary outcome was the cumulative incidence of local tumor progression (LTP) after RFA. Secondary outcomes included technical success rate, technique efficacy, and RFA procedure characteristics. Kaplan-Meier analysis and the Cox proportional hazard regression model were used. Results: The mean follow-up period was 24.1 months. A sufficient ablative margin was more frequently achieved in the no-touch RFA group (57/60 = 95%) than in the conventional RFA group (50/64 = 78.1%) on immediate follow-up CT (p = 0.01). The cumulative incidence of LTP in the no-touch RFA group was significantly lower than that in the conventional RFA group (p = 0.02). In multivariable analysis, no-touch RFA was the only predictive factor for LTP (p = 0.04, hazard ratio = 0.2, 95% confidence interval = 0.04–0.94). Conclusions: A switching monopolar no-touch RFA technique is a favorable treatment option and provides lower LTP after RFA compared with conventional RFA for small HCC.
Liver Cancer

中文翻译：

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使用章鱼电极切换单极无接触射频消融治疗小肝癌：一项随机临床试验

简介：一种开关单极无接触射频消融（RFA）技术用于小肝癌（HCC）；然而，还没有任何随机临床试验将该技术与传统 RFA 技术进行比较。目的：本研究旨在比较两种RFA技术的结果，并比较确定更有效的方法来减少与小HCC（≤2.5 cm）相关的局部肿瘤的进展。方法：这项前瞻性随机临床试验 (NCT03375281) 在 2016 年 10 月至 2017 年 9 月期间共招募了 116 名参与者（男：女，93:23；68.3 ± 8.4 岁）。主要结果是术后局部肿瘤进展 (LTP) 的累积发生率射频消融。次要结果包括技术成功率、技术有效性和 RFA 程序特征。使用 Kaplan-Meier 分析和 Cox 比例风险回归模型。结果：平均随访时间为24.1个月。在立即随访 CT 上，非接触式 RFA 组 (57/60 = 95%) 比传统 RFA 组 (50/64 = 78.1%) 更频繁地获得足够的烧蚀边缘 ( p= 0.01)。非接触式RFA组LTP累积发生率显着低于常规RFA组（p =0.02）。在多变量分析中，非接触式 RFA 是 LTP 的唯一预测因素（p = 0.04，风险比 = 0.2，95% 置信区间 = 0.04-0.94）。结论：开关单极非接触式 RFA 技术是一种有利的治疗选择，与传统 RFA 相比，RFA 后小 HCC 的 LTP 较低。
肝癌