Combination of Minimally Invasive Interventional Radiology Therapy of Hepatocellular Carcinoma: A Case Report [Conference Winner Abstract]

Introduction Hepatocellular carcinoma (HCC), which accounts for over 90% of primary liver cancers, is a major global health concern and the third leading cause of cancer-related deaths [1]. Despite recent advances and improvements in surgical technique for HCC treatment, recurrence occurs in 50% to 80% at 5 years after resection[1,2]. Local ablative therapy for recurrent HCC is considered a key factor in improving the prognosis of HCC [1]. This case report highlights the effective use of TACE followed by CT-guided radiofrequency ablation (RFA) in a patient with recurrent HCC lesions. Case Presentation A 72-year-old female with HCC in segments S2/3 (pT2, N0, M0) underwent a laparoscopic left lobectomy in 2019. In 2022, CT imaging revealed a recurrent 57×53 mm lesion in segment S8. The patient underwent CT-guided superselective transarterial chemoembolization (TACE) using 400μm drug-eluting beads loaded with doxorubicin (75 mg). Six weeks later, radiofrequency ablation (RFA) was performed due to incomplete response. Follow-up CT at 1 month showed lesion shrinkage to 33×34 mm, and at 3 months, complete necrosis was confirmed. No vascular invasion or new metastases were observed during subsequent monitoring. Discussion A large body of data supports the safety and efficacy of RFA, a well-tolerated procedure with a mortality rate of 0% to 1.2% and a complication rate of 3% to 7% [1]. In this case, side effects were closely monitored through regular follow-ups, including laboratory testing, clinical assessments, and imaging. Minor post-procedural side effects, such as transient fever and mild pain (Grade 1-2 based on CTCAE criteria), were managed symptomatically with antipyretics and analgesics. No major complications, such as hepatic abscess, bile duct injury, or vascular damage, were observed. RFA is increasingly used for recurrent HCC after hepatectomy, with 5-year overall survival rates ranging from 18% to 51.6% [3]. Conclusions Combination therapy involving RFA and TACE, can be performed in large tumours for the enhancement of anticancer effects resulting in better local focal lesions treatment efficacy and less negative side effects in HCC patients.