Mohkam K, et al. - Here, the researchers compared outcomes of no touch multibipolar radiofrequency ablation (NTM-RFA) and surgical resection (SR) for intermediate-sized hepatocellular carcinoma (HCC). NTM-RFA for solitary intermediate-sized HCC was correlated with less morbidity and more systematized recurrence compared to SR, while the rate of local recurrence was not significantly different. For rescue therapies, most patients with intrahepatic recurrence remained eligible. In turn, this resulted in equivalent long-term oncological results after both treatments.

Methods

• Using the inverse probability of treatment weighting (IPTW), researchers compared the outcomes of patients primarily treated for solitary HCC ranging from 2 to 5 cm by NTM-RFA or SR at a single-center between 2012 and 2016.

Results

• The researchers observed NTM-RFA in 79 patients and SR in 62.
• The 2 groups, after IPTW, became well-balanced for most baseline characteristics including tumor size, location, etiology, severity of underlying liver disease and alpha-fetoprotein level.
• After SR, morbidity was higher (67.9% vs 50.0%, p=0.042) and hospital stay was longer (12 [IQR 8-13] vs 7 [IQR 5-9] days, p < 0.001).
• At 1 and 3 years, local recurrence rates were 5.5% and 10.0% after NTM-RFA and 1.9% and 1.9% after SR, respectively (p=0.065).
• Higher rates of systematized recurrence (within the treated segment or in an adjacent segment within a 2-cm distance from treatment site) were noted after NTM-RFA (7.4% vs 1.9% at 1 year, 27.8% vs 3.3% at 3 years, p=0.008).
• For rescue treatment, most patients with recurrence were eligible, resulting in similar overall (86.7% after NTM-RFA, 91.4% after SR at 3 years, p=0.954) and disease-free survivals (40.8% after NTM-RFA, 56.4% after SR at 3 years, p=0.119).