Background : Thermal ablative therapies continue to demonstrate to be safe and effective for the treatment of patients with non resectable hepatocellular carcinoma. Microwave ablative therapy which is a relatively new technique has the advantage in providing faster ablation of larger tumors due to it큦 capability to perform a high-powered (80-100 W) procedure in contrast to RFA therapies. This study aimed to evaluate MWA treatment of large HCCs (5-7cm) and to assess it큦 effect on local tumor progression, prognostic outcome and patient's survival.o

Methods : Sixty four patients with HCC tumors larger than 5cm were managed by our group from November 2012 to January 2022. For the procedure we used microwave ablation machine HS AMICA, operating at frequency of 2450 MHz and a power up to 100 Watts, using Multiple needle insertions in one or two sessions according to the size of the lesion. Patients were assessed for efficacy and safety. Complete ablation rate, local tumor progression and overall survival analysis were evaluated.

Results : Complete ablation was achieved in 65% of the cases, the other 35% needen a second treatment or a different ablation technique. No major complications or deaths were related to the procedure no matter conventional open surgery or percutaneous ablation was performed but the hospital stay was shorter in the percutaneous group.

Conclusions : Microwave ablation by percutaneous approach is safe and effective in the treatment of large HCC tumor. The survival and local tumor control were acceptable.