Purpose: To evaluate the efficacy of combined TACE and MWA treatment of a single large HCC (> 5 cm and < 10 cm) compared with treatment by TACE alone.
Material and Methods: A prospective comparative study included 90 patients with a single large HCC. The patients were randomized into two groups: group (A) consisted of 45 patients who underwent TACE then MWA after two weeks, and group (B) consisted of 45 patients who underwent TACE alone. Follow up by laboratory investigations (liver functions, CBC, INR & AFP), and Triphasic CT was done after one month, then every three months for one year. The tumor response was evaluated according to mRECIST criteria.
Results: Neither morbidity nor mortality was detected in both groups; only minor complications occurred, more in the group (A). The tumor response of the group (A) was significantly better than group (B) (p = 0.021). Complete response (CR) and partial response (PR) rates in group (A) at 1, 3, 6, and 12 months were 85%, 80%, 62%, and 60%, respectively, while in group (B) were 60%, 52%, 35%, and 22%, respectively. A significant difference was detected regarding the overall survival in favor of combined treatment in comparison to TACE monotherapy (p = 0.032).
Conclusions: Combined TACE and MWA for the treatment of a single large HCC is safe, well-tolerated, more effective, and could prolong patients’ survival in comparison to TACE alone.