Purpose: To compare MWA and RFA combined with TACE for HCC nodules exceeding 3 cm.
Methods: 19 lesions submitted to MWA (G1) were retrospectively compared with a combined treatment group (G2) matching by tumor characteristics (mean size 43 and 45 mm in G1 and G2, respectively). Technical success, complications, complete ablation (CA), and maintained CA (mCA) were evaluated.
Results: Technical success was achieved in all cases. Overall mortality was zero, both in G1 and G2. No significant differences were found in complications rates (3 in G1 and 2 in G2). CA was obtained in 11 (58 %) HCC in G1 and 15 (79 %) in G2 (p = n.s.). CA was obtained in 75.5 % (G1) and 89 % (G2) nodules up to 4 cm, 45 % and 70 % nodules >4 cm, respectively. At statistical analysis, size resulted as predictor for CA only in G1 (mean diameter of CA vs non-CA 39.9 vs. 47.7 mm, p = 0.021). During follow-up (13.1 and 14.4 months in G1 and G2), mCA occurred in 6/19 (32 %) nodules in G1, 8/19 (42 %) in G2.
Conclusion: MWA and combined therapy are comparable as for safety. No significant differences were found in terms of technique effectiveness. Larger randomized studies should be designed to confirm MWA as a valid alternative to combined therapy.
Keywords: Combined therapy; Hepatocellular carcinoma; Microwave ablation; Radiofrequency ablation; Transarterial chemoembolization.