Abstract: Objective To evaluate the safety and efficacy of ultrasound-guided radiofrequency ablation (MWA) for hepatocellular carcinoma (HCC) in special locations, thereby improving the feasibility and clinical application value of this technique. Methods 92 HCC patients treated in our hospital between January 2019 and January 2023 were involved in our study. Among them, 45 patients had HCC in special locations were the observation group. The remaining patients served as the control group. Both groups underwent a treatment regimen of transarterial chemoembolization (TACE) combined with MWA. Clinical efficacy, tumor markers, and survival rates were compared between the two groups. Results At the 1-month follow-up, there was no statistically significant difference in disease control rates between the two groups (P>0.05). Compared with baseline levels, both the observation and control groups showed significant increases in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) after treatment (P<0.05). Additionally, alpha-fetoprotein (AFP), cancer antigen 125 (CA-125), and cancer antigen 199 (CA-199) levels decreased significantly at 1 and 12 months post-treatment in both groups (P<0.05). Regarding long-term survival outcomes, no statistically significant difference was observed in cumulative survival rates between the two groups at 6, 12, 18, and 24 months (Log-rank test: χ²=0.167, 0.875, 1.452, and 2.639; P=0.862, 0.801, 0.651, and 0.208). Conclusion TACE combined with MWA for HCC in special locations demonstrates good feasibility and safety, with comparable disease control rates, changes in tumor marker reductions, and long-term survival rates to those of HCC in common locations.

Key words: Hepatocellular carcinoma in special locations, Radiofrequency ablation, Transcatheter arterial chemoembolization