{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:06:52Z","timestamp":1789175212272,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>We compared multibipolar radiofrequency ablation (mbpRFA) with open liver resection (OLR) or laparoscopic liver resection (LLR) in patients with HCCs within Milan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter cohort study included patients treated by mbpRFA, OLR or LLR for HCC within the Milan Criteria, developed on advanced fibrosis in nine French centres between 2008 and 2018. Adjustments on HCC size\/number, gender, age, ASA, HCV, HBV, metabolic syndrome, chronic alcohol intake, MELD score, serum AFP level, APRI score, cirrhosis, significant portal hypertension and HCC localization were performed using multivariable regressions with centre\u2010robust variance and propensity score\u2010based matching (3:1 nearest\u2010neighbour with calliper &lt;\u20090.1; effective ratios 2.18:1 and 2.43:1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1040 patients were included (median age: 64\u2009years; male 82.9%), with 606, 266 and 168 treated by mbpRFA, LLR and OLR. Most HCCs were solitary (84.8%) and on cirrhosis (89.2%). In months, the follow\u2010up was 50.2 (95% CI: 45.3, 54.3), 43.3 (95% CI: 40.0, 48.6) and 47.4 (95% CI: 40.8, 58.7) for mbpRFA, LLR and OLR patients. After matching, OLR patients had similar overall survival (OS) (HR\u2009=\u20091.05 [CI 95%\u2009=\u20090.65, 1.69],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.853), transplant\u2010free survival (TFS) (HR\u2009=\u20090.91 [CI 95%\u2009=\u20090.56, 1.47];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.690) or recurrence\u2010free survival (RFS) (HR\u2009=\u20090.99 [CI 95%\u2009=\u20090.69, 1.43];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.968) compared to mbpRFA patients but with more severe adverse events (RR\u2009=\u20092.58 [CI 95%\u2009=\u20091.16, 5.71];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and mortality (RR\u2009=\u20094.51 [CI 95%\u2009=\u20091.16, 17.59];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). After matching, LLR patients had better OS (HR\u2009=\u20090.57 [CI 95%\u2009=\u20090.38, 0.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) but similar TFS (HR\u2009=\u20090.77 [CI 95%\u2009=\u20090.55, 1.1];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.152) and more severe adverse events (RR\u2009=\u20092.61 [CI 95%\u2009=\u20091.15, 5.96];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) compared to mbpRFA patients. LLR patients had a better RFS (HR\u2009=\u20090.7 [CI 95%\u2009=\u20090.53, 0.91];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) than mbpRFA patients. When distant\u2010only recurrences were considered in the mbpRFA patients, there was no significant difference in RFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.087). The LLR survival benefit was consistent across pre\u2010specified subgroups, with no interaction surviving correction for multiple testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Minimally invasive modalities (LLR or mbpRFA) should be prioritized when treating early HCC. LLR maximizes oncological outcomes, but mbpRFA maintains optimal TFS with less morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70802","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:56:37Z","timestamp":1784616997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Laparoscopic or Open Liver Resection Versus Multibipolar Radiofrequency Ablation of\n                    <scp>HCC<\/scp>\n                    Within Milan Criteria on Cirrhosis"],"prefix":"10.1111","volume":"46","author":[{"given":"Christian","family":"Hobeika","sequence":"first","affiliation":[{"name":"Department of HPB Surgery and Liver Transplantation Beaujon Hospital, AP\u2010HP, Clichy, Paris\u2010Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Cauchy","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreato\u2010Biliary and Liver Transplantation H\u00f4pitaux Universitaires de Gen\u00e8ve  Gen\u00e8ve Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Rode","sequence":"additional","affiliation":[{"name":"Service de radiologie CHU Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem","family":"Salam\u00e9","sequence":"additional","affiliation":[{"name":"Service de chirurgie Digestive et Transplantation H\u00e9patique CHU Tours, Universit\u00e9 de Tours  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Scatton","sequence":"additional","affiliation":[{"name":"Service de chirurgie h\u00e9patobiliaire et digestive, APHP CHU Piti\u00e9 Salp\u00e9tri\u00e8re  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Service de chirurgie h\u00e9patobiliaire et digestive CHU de Rouen  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panteleimon","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Service de radiologie CHU Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6148-5801","authenticated-orcid":false,"given":"Arnaud","family":"Hocquelet","sequence":"additional","affiliation":[{"name":"Service de radiologie CHU Bordeaux  Bordeaux France"},{"name":"Service of Diagnostic and Interventional Radiology Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Fr\u00e9d\u00e9rique","family":"Manichon","sequence":"additional","affiliation":[{"name":"Service de radiologie H\u00f4pital Croix Rousse  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Aub\u00e9","sequence":"additional","affiliation":[{"name":"Department of Radiology Angers University Hospital, CHU d'Angers  Angers France"},{"name":"Laboratoire HIFIH, EA 3859, UNIV Angers Universit\u00e9 d'Angers  Angers France"},{"name":"Service d'imagerie M\u00e9dicale H\u00f4pital Henri Mondor, APHP, UPEC, Cr\u00e9teil, INSERM U955 \u2013 Equipe 18  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Oberti","sequence":"additional","affiliation":[{"name":"Laboratoire HIFIH, EA 3859, UNIV Angers Universit\u00e9 d'Angers  Angers France"},{"name":"Department of Hepato Gastroenterology Angers University Hospital, CHU d'Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Della","family":"Corte","sequence":"additional","affiliation":[{"name":"Service de radiologie CHU Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Luciani","sequence":"additional","affiliation":[{"name":"Service d'Imagerie M\u00e9dicale AP\u2010HP, H\u00f4pitaux Universitaires Henri Mondor, Facult\u00e9 de Sant\u00e9, Universit\u00e9 Paris Est Cr\u00e9teil. 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