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Article Type

Original Study

Abstract

Objectives This study aimed to evaluate the role and efficacy of combined transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) in the management of patients with large unresectable hepatocellular carcinoma (HCC) in comparison with traditional TACE alone. Background Surgery is still the treatment of choice for patients with HCC when diagnosed at an early stage. Unfortunately, most HCCs are diagnosed at intermediate or advanced stages. RFA is an alternative to partial hepatectomy for early HCC less than 3 cm. TACE is classified as palliative therapy in patients with intermediate-stage HCC. However, neither TACE nor RFA can result in adequate control of large-sized HCCs. Sequential application of TACE and RFA is increasingly being used in the treatment of medium-sized or large-sized HCC to overcome the limitations of each technique. Patients and methods This prospective study included 40 patients (men/women ratio: 31/9) who had a large unresectable HCC (<5 cm in maximum diameter). Patients were divided into two groups: the first group was treated with combined therapy (TACE–RFA) whereas the second group was treated with traditional TACE. Finally, the therapeutic response was evaluated by 1-month postprocedure triphasic computed tomography. Results The 1-month postprocedure triphasic computed tomography indicated that a complete response was achieved in 19/20 patients in group I and 8/20 patients in group II, whereas a partial response was achieved in 1/20 patients in group I and 10/20 patients in group II. A stable disease was observed in 2/20 patients in group II alone. Finally, no evidence of disease progression could be observed in both groups. Conclusion Combined therapy TACE–RFA is superior to TACE alone in achieving better therapeutic effects for patients with large unresectable HCC.

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