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.