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Purpose <p>This retrospective study aimed to confirm the safety and long-term efficacy of a single-session combined treatment approach with transcatheter arterial embolization (TAE) and microwave ablation (MWA) for inoperable small—to intermediate-sized hepatocellular carcinomas (HCC), focusing on their combined benefits for improving local control.</p> Materials and methods <p>All consecutive patients with up to 2 small-to-intermediate HCC lesions (≤ 5&#xa0;cm) treated with a combined single-session MWA-TAE approach were enrolled between April 2020 and October 2023. All procedures were performed in two stages: TAE and MWA. Clinical and radiological follow-up was performed 3, 6, and 12 months after treatment.</p> Results <p>In the 21 enrolled patients (15 males, mean age 75.9 years), post-procedural contrast-enhanced CT scans confirmed a satisfactory ablation zone in all patients (100%), with minor peri-procedural complications reported in three patients (14%). At the last 12-month follow-up, one patient (8%) displayed local tumor progression, previously classified as LR-TR equivocal at the 6-month follow-up, and half of the patients (6 patients, 50%) exhibited distant tumor progression, predominantly in the form of intra-hepatic recurrence.</p> Conclusion <p>The combined approach of TAE and MWA is a promising method to enhance the percutaneous treatment of small to intermediate-sized HCCs with a resulting anatomic ablation area resembling a surgical sub-segmentectomy. This technique can potentially reduce the gap between percutaneous treatment and liver resection outcomes, allowing for a safe and effective option for oncological control in patients with &gt; 3&#xa0;cm lesions.</p> Graphical abstract <p></p>

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Anatomic sub-segmentectomy with single-session combined transcatheter arterial embolization/microwave ablation for the treatment of hepatocellular carcinoma: preliminary results

  • 期刊论文

  • 发表日期：

    2025年2月6日

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  • Silvio Romano,
  • Ezio Lanza,
  • Angela Ammirabile,
  • Giuseppe Ferrillo,
  • Elisavietta Tenuta,
  • Dario Poretti,
  • Marco Francone,
  • Roberto Ceriani,
  • Alessio Aghemo,
  • Guido Torzilli,
  • Vittorio Pedicini

摘要

Purpose

This retrospective study aimed to confirm the safety and long-term efficacy of a single-session combined treatment approach with transcatheter arterial embolization (TAE) and microwave ablation (MWA) for inoperable small—to intermediate-sized hepatocellular carcinomas (HCC), focusing on their combined benefits for improving local control.

Materials and methods

All consecutive patients with up to 2 small-to-intermediate HCC lesions (≤ 5 cm) treated with a combined single-session MWA-TAE approach were enrolled between April 2020 and October 2023. All procedures were performed in two stages: TAE and MWA. Clinical and radiological follow-up was performed 3, 6, and 12 months after treatment.

Results

In the 21 enrolled patients (15 males, mean age 75.9 years), post-procedural contrast-enhanced CT scans confirmed a satisfactory ablation zone in all patients (100%), with minor peri-procedural complications reported in three patients (14%). At the last 12-month follow-up, one patient (8%) displayed local tumor progression, previously classified as LR-TR equivocal at the 6-month follow-up, and half of the patients (6 patients, 50%) exhibited distant tumor progression, predominantly in the form of intra-hepatic recurrence.

Conclusion

The combined approach of TAE and MWA is a promising method to enhance the percutaneous treatment of small to intermediate-sized HCCs with a resulting anatomic ablation area resembling a surgical sub-segmentectomy. This technique can potentially reduce the gap between percutaneous treatment and liver resection outcomes, allowing for a safe and effective option for oncological control in patients with > 3 cm lesions.

Graphical abstract