TACE Combined With Lenvatinib and MWA in the Treatment of Locally Advanced Large Hepatocellular Carcinoma

Inclusion Criteria:

• Patients aged 18-75 years with hepatocellular carcinoma have an expected survival ofat least 3 months;
• Number of tumors ≤ 3;
• Large hepatocellular carcinoma with tumor diameter ≥ 7 cm;
• Patients without inferior vena cava tumor thrombus, portal vein tumor thrombus andcholangiocarcinoma thrombus;
• Although there is arteriovenous fistula or arterioportal fistula, it can be completelyblocked;
• Child Pugh grade A or B of liver function; ECoG physical fitness score < 2;
• No bleeding tendency, normal coagulation function or coagulation dysfunction can becorrected after treatment;
• Leukocyte count ≥ 3.0 × 109/L；
• Hemoglobin ≥ 8.5g/dl;
• Platelet count ≥ 50 × 109/L；
• The international normalized ratio of prothrombin time (INR) ≤ 2.3 or prothrombin time (PT) does not exceed the upper limit of normal control for 3 seconds;
• Serum creatinine was less than 1.5 times of the upper limit of normal;
• Patients and / or family members agree to join the clinical trial and sign theinformed consent form

Exclusion Criteria:

• Diffuse hepatocellular carcinoma;
• Portal vein tumor thrombus;
• Combined with tumor thrombus of hepatic vein and inferior vena cava;
• Patients with lymph node metastasis and extrahepatic distant metastasis;
• The liver function was classified as child Pugh C and could not be improved by liverprotection treatment;
• Arteriovenous fistula or arterioportal fistula with ineffective intervention;
• Uncorrectable coagulation dysfunction and obvious hemogram abnormalities, with obviousbleeding tendency;
• Intractable massive ascites;
• ECoG physical fitness score > 2 points;
• Combined with active infection, especially bile duct inflammation;
• Serious heart, lung, kidney, brain and other important organ diseases;
• Note: see attached table 1 for child Pugh classification of liver function; Seeattached table 2 for ECoG physical fitness score