Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2025; 31(28): 109078
Published online Jul 28, 2025. doi: 10.3748/wjg.v31.i28.109078
Efficacy and safety of transcatheter arterial chemoembolization combined with microwave ablation for hepatic hemangiomas (> 5 cm)
Jia-Peng Sun, Kang Zhou, Jie Pan, Ning Yang, Xiao-Nan Sun, Hai-Tao Zhao, Xiao-Bo Yang
Jia-Peng Sun, Kang Zhou, Jie Pan, Ning Yang, Xiao-Nan Sun, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Hai-Tao Zhao, Xiao-Bo Yang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Co-first authors: Jia-Peng Sun and Kang Zhou.
Author contributions: Sun JP, Zhou K, Pan J, Yang N, and Sun XN designed the research study; Sun JP and Zhou K contributed equally to this article, they are the co-first authors of this manuscript; Sun JP, Zhou K, Yang N, and Sun XN performed the research and acquired the data; Zhao HT and Yang XB contributed to the multidisciplinary evaluation of patients; Sun JP and Zhou K analyzed the data; Sun JP, Zhou K, Pan J, Zhao HT, and Yang XB wrote and critically revised the manuscript; and all authors have read and approve the final manuscript.
Supported by the Peking Union Medical College Hospital Central High-Level Hospital Clinical Research Project, No. 2022-PUMCH-B-069.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Peking Union Medical College Hospital, approval No. 1-24PJ1959.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Participants gave informed consent for data sharing. Dataset available from the corresponding author at markpan6885@sina.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Pan, MD, Chief, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. markpan6885@sina.com
Received: April 29, 2025
Revised: May 24, 2025
Accepted: July 4, 2025
Published online: July 28, 2025
Processing time: 86 Days and 17.9 Hours
Abstract
BACKGROUND

Hepatic hemangiomas represent the most prevalent benign liver tumors. Surgical management of large symptomatic hepatic hemangiomas remains controversial and there is an increasing interest in minimally invasive techniques, such as transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA).

AIM

To evaluate the efficacy and safety of TACE combined with MWA for large hepatic hemangiomas.

METHODS

This retrospective cohort study was conducted at Peking Union Medical College Hospital between January 2015 and January 2024. Eighty-two patients with hepatic hemangiomas > 5 cm were divided into two groups: Observation (TACE + MWA, n = 50) and control (TACE, n = 32). Tumor diameter and treatment outcomes were evaluated at baseline, 12 months, and > 3 years. Appropriate statistical tests were chosen based on the type and distribution of the data.

RESULTS

At baseline, the median tumor diameter was 8.3 (range: 5.0-19.2) cm in the observation group and 8.5 (range: 5.0-20.0) cm in the control group. The median follow-up duration was 44.6 (95% confidence interval: 36.7-52.5) months. At 12 months post-treatment, the observation group demonstrated a higher tumor reduction ratio compared to the control group (50.98% vs 23.28%, respectively; P < 0.001). The objective response rate was 93.94% in the observation group, which was significantly higher than that in the control group (33.33%) (P < 0.001). No recurrence occurred in the observation group, while one case occurred in the control group. Notably, no cases of hemoglobinuria or acute kidney injury were reported in the observation group.

CONCLUSION

Combination treatment enhances tumor shrinkage, promotes long-term tumor control, and reduces the complications associated with MWA, thereby presenting a promising alternative to surgical resection.

Keywords: Hepatic hemangioma; Transcatheter arterial chemoembolization; Microwave ablation; Interventional treatment; Safety; Liver

Core Tip: This study compares two treatment options for large liver hemangiomas, a type of benign tumor. We found that combining transcatheter arterial chemoembolization and microwave ablation was more effective at shrinking tumors and preventing recurrence compared to transcatheter arterial chemoembolization alone. Patients with large liver hemangiomas experienced fewer complications on the combined treatment which may be a safer alternative to surgery.