Abstract: Background & Aims: Hepatocellular carcinoma (HCC) is the fifth most common cancer
and the second leading cause of cancer-related deaths. The only definitive treatment for both HCC
and cirrhosis is liver transplantation, but long wait times in some regions and a relatively fixed
number of donor organs negatively impact access to liver transplantation. The aim of the work was
to evaluate and compare the short outcome of patients with medium-sized HCC who will undergo
percutaneous microwave ablation (MWA) alone and in combination with TACE.
Methods: This prospective study included 40 patients with medium-sized HCC lesions who were
classified into two groups; Group A that included twenty patients treated by TACE followed by percutaneous
MWA after 2 weeks and group B that included twenty patients treated by 2 sessions of
percutaneous MWA with 2 weeks interval. Full history taking, clinical examination, laboratory investigation,
abdominal ultrasonography and abdominal tri-phasic computed tomography (CT) with
contrast were obtained from the two groups. Laboratory and radiological follow up of the cases
were done at 1 and 3 months after the treatment.
Results: There was no statistically significant difference in the sociodemographic criteria, laboratory
measurement and clinical criteria between the cases in the two study groups before initiation of
treatment. The response was slightly better in the combined treatment group, but it did not show a
statistically significant difference. The incidence of complications was higher in the MWA group.
Conclusion: Hepatocellular carcinoma is a common complication of HCV related cirrhosis. Association
of TACE-MWA led to better response rates than MWA with fewer complications.