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 of at 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 and cholangiocarcinoma thrombus;
* Although there is arteriovenous fistula or arterioportal fistula, it can be completely blocked;
* Child Pugh grade A or B of liver function; ECoG physical fitness score \< 2;
* No bleeding tendency, normal coagulation function or coagulation dysfunction can be corrected 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 the informed 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 liver protection treatment;
* Arteriovenous fistula or arterioportal fistula with ineffective intervention;
* Uncorrectable coagulation dysfunction and obvious hemogram abnormalities, with obvious bleeding 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; See attached table 2 for ECoG physical fitness score