Yu Y, Yuan W, Lei J, Zhao CB, Tao CG, Liu SH, Wang BL. Synchronous vs sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma: Efficacy and prognosis. World J Gastrointest Surg 2026; 18(2): 114378 [DOI: 10.4240/wjgs.v18.i2.114378]
Corresponding Author of This Article
Bai-Lin Wang, PhD, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Middle Road, Guangzhou 510220, Guangdong Province, China. nini520o@163.com
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Gastroenterology & Hepatology
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Observational Study
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Feb 27, 2026 (publication date) through Feb 26, 2026
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World Journal of Gastrointestinal Surgery
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Yu Y, Yuan W, Lei J, Zhao CB, Tao CG, Liu SH, Wang BL. Synchronous vs sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma: Efficacy and prognosis. World J Gastrointest Surg 2026; 18(2): 114378 [DOI: 10.4240/wjgs.v18.i2.114378]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 114378 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114378
Synchronous vs sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma: Efficacy and prognosis
Yi Yu, Wei Yuan, Jin Lei, Chun-Bo Zhao, Cheng-Gang Tao, Sheng-Hui Liu, Bai-Lin Wang
Yi Yu, Wei Yuan, Bai-Lin Wang, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510220, Guangdong Province, China
Jin Lei, First Clinical Medical College, Xiangnan College, Chenzhou 423000, Hunan Province, China
Chun-Bo Zhao, Cheng-Gang Tao, Sheng-Hui Liu, Department of Hepatobiliary Surgery, The First People's Hospital of Chenzhou City, Chenzhou 423000, Hunan Province, China
Author contributions: Yu Y designed and performed the research; Wang BL designed the research and supervised the report; all authors collected and analyzed data and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Guangzhou Red Cross Hospital of Jinan University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
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: No additional data are available.
Corresponding author: Bai-Lin Wang, PhD, Department of Hepatobiliary Surgery, Guangzhou Red Cross Hospital of Jinan University, No. 396 Tongfu Middle Road, Guangzhou 510220, Guangdong Province, China. nini520o@163.com
Received: November 4, 2025 Revised: December 21, 2025 Accepted: January 7, 2026 Published online: February 27, 2026 Processing time: 113 Days and 22.4 Hours
Abstract
BACKGROUND
Despite therapeutic advances, outcomes in hepatocellular carcinoma (HCC) remain suboptimal, underscoring the need to explore more effective treatment strategies.
AIM
To compare efficacy and prognosis in HCC patients treated with synchronous vs sequential transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA).
METHODS
A total of 106 patients with HCC admitted between March 2022 and March 2024 were included. Patients receiving concurrent TACE and MWA constituted the synchronous group (n = 56), while those treated with TACE followed by MWA formed the sequential group (n = 50). Intergroup comparisons encompassed curative efficacy, ablation-related parameters (number of needle insertions, ablation duration, and power), prognostic indicators (progression-free survival and overall survival), tumor biomarkers [alpha-fetoprotein (AFP), AFP-L3], hepatic function indices [total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], and post-procedural complications (pyrexia, abdominal pain, and gastrointestinal reactions).
RESULTS
No significant intergroup differences were observed in curative efficacy, ablation power, prognosis, or overall complication rates (P > 0.05). However, the synchronous group required fewer ablation needles and shorter ablation durations than the sequential group (P < 0.05), AFP, AFP-L3, TBIL, ALT, and AST levels significantly decreased after treatment in both groups (P < 0.05), with no significant differences between groups (P > 0.05).
CONCLUSION
Synchronous TACE combined with MWA is non-inferior to the sequential approach regarding therapeutic efficacy, survival outcomes, safety, and tumor control in HCC. Notably, the synchronous strategy offers procedural advantages by reducing ablation attempts and shortening treatment duration.
Core Tip: This study comparatively evaluated synchronous versus sequential combinations of transcatheter arterial chemoembolization and microwave ablation for hepatocellular carcinoma. Both strategies effectively controlled tumor lesions, inhibited tumor markers, and improved liver function, with no significant differences in patient outcomes. Importantly, the synchronous approach significantly reduced ablation attempts and procedure duration, indicating a modest procedural advantage over the sequential regimen.
