Combined Percutaneous Microwave Ablation (MWA) and Transarterial Chemoembolization (TACE) for the treatment of intermediate and large-sized HCC nodules

Locoregional therapies are useful for the treatment of unresectable hepatocellular carcinoma (HCC). Radiofrequency thermal ablation (RFA) is considered the standard of care for patients with lesions smaller than 3 cm in diameter not suitable for surgery. However the likelihood of complete ablation using RFA declines rapidly as tumor diameter is greater than 3 cm. The combination of RFA and transarterial chemoembolization (TACE) has resulted in higher percentage of complete necrosis of the HCCs over 3 cm. Microwaves ablation (MWA) has recently emerged as a new technique promising larger and faster ablation areas without some of the RFA limitations. In literature there are few studies reporting the experience of treating HCCs larger than 3 cm with the combination of TACE and MWA, with encouraging results in terms of local tumor control. In this study we have retrospectively reported results of our single experience using TACE combined with MWA in the treatment of intermediate and large HCCs.