Abstract: Objective To evaluate the efficacy of transcatheter hepatic arterial chemoembolization (TACE) combined with ultrasound-guided microwave ablation (MWA) in the treatment of isolated caudate lobe hepatocellular carcinoma (HCC). Methods A retrospective analysis was conducted on 70 patients with isolated caudate lobe HCC who were treated at Leshan People's Hospital between January 2015 and January 2022. The patients were divided into an observation group (34 patients treated with TACE combined with MWA) and a control group (36 patients treated with TACE alone). Preoperative clinical data, one-month postoperative serum tumor markers, liver function indicators, clinical efficacy, incidence of postoperative adverse reactions, and 2-year overall survival (OS) rate were recorded and compared between the two groups. Results There was no statistically significant difference in preoperative clinical data such as age, gender, tumor diameter, Child-Pugh grade, presence of hepatitis, and cirrhosis between the two groups (all P>0.05). One month after surgery, the levels of serum tumor markers alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and vascular endothelial growth factor (VEGF) in the observation group were (124.04±13.41) ng/mL,(3.69±1.47) ng/mL, and (237.64±26.86) ng/L, respectively, which were lower than those in the control group [(144.68±13.82) ng/mL, (3.48±1.44) ng/mL, and (263.93±27.17) ng/L], respectively. Among them, the differences in AFP and VEGF levels between the two groups were statistically significant (t=6.338, 4.068, respectively, both P<0.05). One month after surgery, the liver function indicators of total bilirubin (TBil), albumin (Alb), and alanine aminotransferase (ALT) in the observation group were (18.55±1.93) μmol/L, (37.68±4.13) g/L, and (44.36±4.19) U/L, respectively, which were lower than those in the control group [(21.07±2.02) μmol/L, (36.39±5.90) g/L, and (51.40±4.10)U/L, respectively. Among them, the differences in TBil and ALT levels between the two groups were statistically significant (t=5.309, 7.092, respectively, both P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05). One month after surgery, the objective response rate in the observation group was 79.4%, significantly higher than that in the control group (55.6%) (χ²=4.511, P<0.05). Two years after surgery, the OS rate in the observation group was 70.6%, significantly higher than that in the control group (44.4%) (χ²=4.880, P<0.05). Conclusion Compared with TACE alone, TACE combined with MWA for the treatment of isolated caudate lobe HCC can effectively improve early clinical efficacy and two-year OS.

Key words: Transcatheter hepatic arterial chemoembolization, Liver cancer, Ablation