title: Transarterial Chemoembolization Combined with Either Radiofrequency or Microwave Ablation in Management of Hepatocellular Carcinoma
abstract: Introduction: Local ablative therapy and trans arterial chemoembolization (TACE) are applied to ablate non
  resectable hepatocellular carcinoma (HCC). Combination of both techniques has proven to be more effective. We
  aimed to study combined ablation techniques and assess survival benefit comparing TACE with radiofrequency (RFA)
  versus TACE with microwave (MWA) techniques. Methods: We retrospectively studied 22 patients who were ablated
  using TACE-RFA and 45 with TACE-MWA. All were classified as Child A-B and lesions did not exceed 5 cm in
  diameter. TACE was followed within two weeks by either RFA or MWA. We recorded total and partial ablation rates
  and complication rates. Survival analysis was then performed. Results: TACE-MWA showed a higher tendency to
  provide complete response rates than TACE-RFA (P 0.06). This was particularly evident with lesions sized 3-5 cm (P
  0.01). Rates of complications showed no significant difference between the groups. Overall median survival was 27
  months. The overall actuarial probability of survival was 80.1% at 1 year, 55% at 2 years, and 36.3% at 3 years. The
  recurrence free survival at 1 year, 2years and 3 years for the TACE-RFA group was 70%, 42% and 14% respectively
  and for TACE-MWA group 81.2%, 65.1% and 65.1% without any significant difference (P 0.1). In relation to the size of
  focal lesions, no statistically significant difference in the survival rates was detected between the groups. Conclusion:
  TACE-MWA led to better response rates than TACE-RFA with tumors 3-5 cm, with no difference in survival rates.
authors.affiliation: Endemic Medicine and Hepatogastroenterology Department, Cairo University, Cairo, Egypt. Email: hendshousha@yahoo.com
authors.forename: Ashraf Omar
authors.initials: AO
authors.lastname: Abdelaziz
authors.forename: Ahmed Hosni
authors.initials: AH
authors.lastname: Abdelmaksoud
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Nabeel
authors.forename: Hend Ibrahim
authors.initials: HI
authors.lastname: Shousha
authors.forename: Ahmed Abdelmonem
authors.initials: AA
authors.lastname: Cordie
authors.forename: Sherif Hamdy
authors.initials: ShH
authors.lastname: Mahmoud
authors.forename: Eman
authors.initials: E
authors.lastname: Medhat
authors.forename: Dalia
authors.initials: D
authors.lastname: Omran
authors.forename: Tamer Mahmoud
authors.initials: TM
authors.lastname: Elbaz
keywords: Hepatocellular carcinoma; microwave ablation; radiofrequency ablation