Transcatheter arterial chemoembolization alone versus combined with microwave ablation for recurrent small hepatocellular carcinoma after resection: A retrospective comparative study

Purpose: To compare the efficacy and safety of transcatheter arterial chemoembolization combined with microwave ablation (TACE-MWA) versus TACE alone for the treatment of recurrent small hepatocellular carcinoma (sHCC) after resection. Materials: and Methods: From June 2015 to January 2020, a total of 45 patients with recurrent sHCC (size ≤ 3cm) treated by TACE-MWA or TACE were included in this study. The radiological response at 1 month after initial treatment [modified Response Evaluation Criteria in Solid Tumors (mRECIST)], progression-free survival (PFS), overall survival (OS), and complications were evaluated. Results: The TACE-MWA group showed a better 1-month complete response (CR) rate (82.3% vs. 42.8%, P = 0.013). The corresponding 1-, 3-, and 5-year PFS rates were 76.5%, 70.6%, and 70.6% for the TACE-MWA group, and 56.1%, 15.0%, and 15.0% for the TACE group (P = 0.003). The 1-, 3-, and 5-year OS rates were 100.0%, 82.1%, and 61.5% for the TACE-MWA group, and 89.0%, 58.1%, and 50.8% for the TACE group (P = 0.389), respectively. Moreover, no major complications related to treatment were observed in either of the groups. Compared with the TACE group, the TACE-MWA group had a significantly lower number of re-TACE sessions (P = 0.003). Conclusions: Although TACE alone provides equivalent effectiveness for recurrent sHCC in terms of OS rates, TACE-MWA leads to a better tumor response at 1 month and may prolong tumor PFS time.