Combined therapy with microwave ablation and conventional transarterial chemoembolization for hepatocellular carcinoma tumors larger than five centimetres - a prospective study

Q: What was the primary aim of this prospective study?

To compare the safety and efficacy of combined MWA plus conventional TACE versus TACE alone for treating HCC tumors ≥5 cm.

Q: How were patients and treatment groups organized?

The study enrolled 186 patients with HCC tumors ≥5 cm and divided them into a test group receiving TACE + MWA and a control group receiving TACE only.

Q: Which outcomes showed superiority for TACE + MWA?

TACE + MWA produced a significantly higher tumor necrosis ratio, greater AFP reduction and AFP variation rate, improved partial/overall response rates, and a higher disease control rate compared with TACE alone.

Sep 29, 2026

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Prospective study evaluating combined microwave ablation (MWA) and transarterial chemoembolization (TACE) versus TACE alone for hepatocellular carcinoma (HCC) tumors ≥5 cm. A total of 186 patients were assigned to TACE+MWA (n=?) or TACE only, with tumor size averaging 9.2±3.7 cm. Outcomes included tumor necrosis ratio, partial response, progressive disease, overall response, disease control, and serum AFP changes. TACE+MWA achieved higher necrosis ratio and improved response metrics with greater AFP reduction and variation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Purpose

Methods

Participants and grouping

Measurements and assessment

Results

Conclusion

Clinical significance

Keywords

Copyright @ 2026 Author(s) -[Available online at dirjournal.org.](Available online at dirjournal.org. ORIGINAL)[ ORIGINAL](Available online at dirjournal.org. ORIGINAL) ARTICLE Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Combined therapy with microwave ablation and conventional transarterial chemoembolization for hepatocellular carcinoma tumors larger than five centimetres: a prospective study Hui Liu 1* Zhuoyang Fan2* Ranying Zhang 1 Xingwei Zhang 1 Jianhua Wang2 1Fudan University Zhongshan Hospital, Department of Radiology, Shanghai, China 2Fudan University Zhongshan Hospital, Department of Interventional Radiology, Shanghai, China *Joint first authors Corresponding author: Jianhua Wang [E-mail:](E-mail: wjh1953a@163.com)[ wjh1953a@163.com](E-mail: wjh1953a@163.com) Received 21 February 2025; revision requested 13 April 2025; last revision received 12 May 2025; accepted 18 May 2025 Epub: 07.07.2025 Publication date: 02.01.2026 DOI: 10.4274/dir.2025.253308 PURPOSE This study aimed to compare the safety and efficacy of a combined therapy involving microwave ablation (MWA) and transarterial chemoembolization (TACE) versus only TACE for the treatment of hepatocellular carcinoma (HCC) tumors ≥5 cm. METHODS This prospective study enrolled 186 patients with HCC tumors ≥5 cm. Patients were divided into a test group (TACE + MWA) and a control group (TACE only). The average tumor size was 9.2 ± 3.7 cm, ranging from 5 to 19 cm. Forty-five patients (27.4%) had Barcelona Clinic Liver Cancer class A disease, and 119 (72.6%) had class B disease. The viable tumor volume was quantified utilizing ITKSNAP, a free and open-source software package for medical image segmentation and visualization, along with contrast-enhanced magnetic resonance imaging. The tumor response was assessed according to the modified response evaluation criteria in solid tumors rules. Serum alpha-fetoprotein (AFP) levels were monitored, and the tumor necrosis ratio and AFP variation rate were calculated. RESULTS The final analysis of 164 patients (median age 57 years, range 26–80 years; 19 women, 145 men) showed that the test group exhibited a significantly higher tumor necrosis ratio than the control group (87.5% vs. 76.1%, P = 0.002). The serum AFP levels were markedly reduced in the test group relative to the control group 30 days after surgery (P = 0.001) . The AFP variation rate in the test group (79.5%) was significantly greater than that observed in the control group (47.5%) (P < 0.001) . A significant positive correlation existed between the tumor necrosis ratio and AFP variation rate (P < 0.001) . Compared with the control group, the test group demonstrated a significantly higher partial response rate (68.6% vs. 51.3%, P < 0.05), a lower rate of progressive disease (17.4% vs. 35.9%, P < 0.05), an increased overall response rate (70.9% vs. 55.1%, P = 0.036), and an enhanced disease control rate (82.6% vs. 64.1%, P = 0.007) . Post-MWA, 3 patients experienced hemorrhage and 2 developed arteriovenous fistulae, all of which were treated with embolization. CONCLUSION The combination of TACE and MWA demonstrated safety, good tolerability, and greater efficacy compared with TACE alone for HCC tumors ≥5 cm. CLINICAL SIGNIFICANCE The combination of TACE and MWA offers new possibilities for improving tumor necrosis rates, reducing AFP levels, and enhancing short-term prognosis. These findings not only provide new treatment options for clinical doctors but also promote the application of three-dimensional quantitative assessment technology and provide important references for future research and clinical practice. KEYWORDS Hepatocellular carcinoma, microwave ablation, therapeutic evaluation, three-dimensional, transarterial chemoembolization You may cite this article as: Liu H, Fan Z, Zhang R, Zhang X, Wang J. Combined therapy with microwave ablati

FAQs

What was the primary aim of this prospective study?

To compare the safety and efficacy of combined MWA plus conventional TACE versus TACE alone for treating HCC tumors ≥5 cm.

How were patients and treatment groups organized?

The study enrolled 186 patients with HCC tumors ≥5 cm and divided them into a test group receiving TACE + MWA and a control group receiving TACE only.

Which outcomes showed superiority for TACE + MWA?

TACE + MWA produced a significantly higher tumor necrosis ratio, greater AFP reduction and AFP variation rate, improved partial/overall response rates, and a higher disease control rate compared with TACE alone.

Sep 29, 2026

Uploaded by Aditya