OBJECTIVE:Apatinib is a novel inhibitor of vascular endothelial growth factor receptor-2. The goal of this study was to evaluate overall survival (OS) after a combination of transarterial chemoembolization (TACE) and apatinib in patients with advanced hepatocellular carcinoma (HCC) and to identify the factors affecting patient survival.METHODS:Fifty-one patients with advanced HCC who received TACE in combination with apatinib in our hospital from June 2015 to May 2017 were enrolled. The OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. The log-rank test and Cox regression model were used to determine the factors affecting OS.RESULTS:The median OS and PFS of the patients were 15 months and 10 months, respectively. The 1-, 2-, and 3-year survival rates were 64.7%, 23.5%, and 1.8%, respectively. Univariate survival analysis showed that patients with Child-Pugh A (P=0.006), reduction rate of proper hepatic artery (P=0.016), hand-foot syndrome (P=0.005), secondary hypertension (P=0.050), and without ascites (P=0.010) had a better OS. Multivariate analysis showed that hand-foot syndrome (P=0.014), secondary hypertension (P=0.017), and reduction rate of proper hepatic artery (P=0.025) were independent predictors of better OS.CONCLUSION:TACE combined with apatinib is a promising treatment for advanced HCC. Hand-foot syndrome, secondary hypertension, and the reduction rate of proper hepatic artery were associated with a better OS.

Abstract PurposeThere has been no study on the complications of liver abscess in patients treated with Transarterial chemoembolization (TACE) combined with molecular targeted drugs and immunotherapy (TACE-M-I). The aim of this study was to examine the complications of liver abscess in patients treated with TACE alone, TACE-M, or TACE-M-I.MethodsWe retrospectively reviewed data on patients with liver cancer who received TACE in our institution between January 2016 and November 2020. A total of 2203 patients received 5286 TACE: 78 patients received TACE-M, 28 patients received TACE-M-I, and 68 patients received TACE. ResultsIn this study, a total of 12 patients developed liver abscess after TACE; among them, 1 patient developed liver abscess after TACE-M, and 2 patients developed liver abscess after TACE-M-I. The incidence of liver abscess was 0.43% (9/2097) among all patients who received TACE and 1.3% (1/78) among patients who received TACE-M. The incidence of liver abscess in patients who received TACE-M-I was 7.1% (2/28). After infection, ALT, AST, creatine, leukocyte, and neutrophil were higher than those before TACE. After drainage of the abscess and the application of antibacterial agents, the ALT, leukocyte, and neutrophil decreased to normal levels. All patients recovered and were discharged after liver abscess treatment.ConclusionLiver abscess is a rare complication after TACE, but molecular targeted drugs and immunotherapy might increase the incidence of liver abscess for patients who received TACE. Clinicians should focus on caring for these patients. Abscess drainage and antibacterial agents are good treatment choices for these patients.

OBJECTIVES:The purpose of this study was to evaluate the efficacy and safety of transarterial chemoembolization (TACE) in the treatment of patients with treatment-naïve hepatocellular carcinoma (TN-HCC) and recurrent HCC (R-HCC). In addition, risk signature analysis was performed to accurately assess patients' recurrence and survival.METHODS:This retrospective study assessed the consecutive medical records of TN-HCC and R-HCC patients from January 2014 to December 2018. In order to reduce the patient selection bias, propensity score matching (PSM) analysis was applied. Conditional inference tree was used to establish a risk signature.RESULTS:A total of 401 eligible patients were included in our study, including 346 patients in the TN-HCC group and 55 patients in the R-HCC group. Forty-seven pairs of patients were chosen after the PSM analysis. Before the PSM analysis, the objective tumor regression (ORR) and disease control rate (DCR) of R-HCC patients were better than that of TN-HCC patients; however, after the PSM analysis, there was no significant difference in the ORR and DCR between the two groups (P>0.05). Before the PSM analysis, the median overall survival (OS) and progression-free survival (PFS) in the R-HCC group were significantly greater than those of the TN-HCC group (OS: 24 months vs. 18 months, P =0.004; PFS: 9 months vs. 6 months, P =0.012). However, after the PSM analysis, the median OS and PFS in the R-HCC group were inferior to those in the TN-HCC group (OS: 24 months vs. 33 months, P= 0.0035; PFS: 10 months vs. 12 months, P = 0.01). The conditional inference tree divided patients into different subgroups according to tumor size, BCLC stage, and TACE sessions and shared different hazards ratio to recurrence or survival.CONCLUSION:Patients with R-HCC treated with TACE achieved satisfactory results, although survival after the PSM analysis was not as good as in the TN-HCC group. In addition, risk signature based on conditional inference tree analysis can more accurately predict the recurrence and survival in both groups of patients.

目的 总结介入治疗肾动静脉分流的疗效及治疗策略.方法 回顾性分析33例肾动静脉分流患者的临床资料,分析总结其介入治疗的安全性、有效性及治疗策略.结果 保守治疗3例,介入治疗30例.共行介入手术32次,3例手术失败,技术成功率90.6％.患者症状均于术后3天内消失,围手术期未发生严重并发症,即时临床成功率93.7％.平均随访33.9个月,保守治疗组中,1例随访3年时出现症状后成功行介入治疗;介入治疗组中,1例于术后1个月血尿复发再次行介入治疗失败,余无异常,综合临床成功率为90.6％.结论 肾动静脉分流介入治疗安全、有效,应被视为一线治疗手段.

Objective: This study aimed to classify hepatocellular carcinomas (HCCs) according to their diameter using statistic technology and evaluate the prognosis of the classified groups after the combined use of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). Materials and Methods: Electronic medical records of 128 consecutive patients who underwent TACE-RFA as the initial treatment for HCC from January 2010 to April 2018 were retrospectively analyzed. TACE was initially performed with subsequent RFA performed after 3-7 days. The decision tree model was used to classify overall survival (OS), progression-free survival (PFS), local recurrence rate (LRR), and treatment complications in HCC. Results: The tumors were divided into three groups of sizes <= 2.9 cm, 2.9-4.8 cm, and >4.8 cm. The group of tumors >4.8 cm showed inferior OS, PFS, and LRR than the other two groups (P < 0.05) on long-term follow-up but not in the first 6 months (P > 0.05). The groups of tumors <= 2.9 cm and 2.9-4.8 cm showed no statistically significant difference in OS, PFS, and LRR (P > 0.05). Conclusions: The cutoff points of 2.9 and 4.8 cm were achieved using the objective decision tree model rather than the artificial division of 3 and 5 cm. The prognosis was not significantly different between the groups of tumors <= 2.9 cm and 2.9-4.8 cm, and the prognosis of the two groups was better than the group of tumors >4.8 cm in the long-term follow-up but not in the first 6 months.

目的 研究移植肾动脉狭窄(TRAS)的临床特点及介入治疗的疗效.方法 回顾性分析TRAS患者的临床资料,排除临床资料不完整者,分析总结其临床特点、诊断方法及介入治疗的疗效.结果 共搜集病例31例,行介入手术35次.6例行单纯球囊扩张(PTA),24例行支架置入,1例手术失败.术后肾动脉狭窄程度、肾功能及血压明显改善,围手术期未发生严重并发症;平均随访29.6个月,PTA术后2例(33.3％)复发狭窄,行支架置入术无复发;支架术后3例(12.5％)再发狭窄,2例成功行PTA术后无复发.结论 肾移植术后密切超声随访有利于早期诊断TRAS,介入治疗TRAS安全、有效且应被视为一线治疗方法.

Objectives To explore the candidates, efficacy and safety of interventional therapies in the treatment of portal vein occlusion (PVO). Methods In our study, 13 patients diagnosed with PVO were included. Of all 13 patients, two received percutaneous portal vein recanalization (PVR), 10 received PVR and transjugular intrahepatic portosystemic shunt (PVR-TIPS), and one underwent intrahepatic portal branch-large collateral vessel shunt. Results Interventional approaches were completed in all patients, and the technical success rate was 100%. The portal pressure gradient of patients treated with PVR-TIPS fell from 31 ± 4 to 12 ± 3 mmHg. During the procedures, no life-threatening complications occurred. All the clinical symptoms were effectively controlled after the interventional therapies and all the patients survived during the follow-up, with no rebleeding or overt hepatic encephalopathy. But stent thrombosis occurred in one patient, the cumulative rate of stent patency was 92%. Conclusion Interventional therapy was proved to be a well tolerated and effective strategy for PVO. For PVO patients without high intrahepatic resistance, if the patient is equipped with available portal inflow tract (superior mesenteric vein or splenic vein) and outflow tract (intrahepatic portal branches), PVR is the first choice; if the outflow tract is completely blocked with only available inflow tract, PVR-TIPS can be considered. For PVO patients with high intrahepatic resistance, as long as there is an available portal inflow tract, PVR-TIPS can be adopted.

Evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) insertion on patients with schistosomiasis-induced liver fibrosis, and compare with that of patients with HBV-induced cirrhosis. This was a retrospective study from November 2015 to December 2018 including 82 patients diagnosed with portal hypertension, one group of which is induced by schistosomiasis (n = 20), the other by hepatitis B virus (HBV) (n = 62). Both groups of subjects underwent TIPS placement for the management of portal hypertension complications. TIPS was inserted successfully in all patients (technical success 100%). After a median follow-up of 14 months following TIPS insertion, portal pressure gradient (PPG) value in both schistosomiasis-induced group and HBV-induced group underwent a significant decrease with no major difference between the two groups. There exists no significant difference demonstrated by Kaplan–Meier curves between two groups concerning cumulative rate of hepatic encephalopathy (HE) (log-rank p = 0.681), variceal rebleeding (log-rank p = 0.837) and survival (log-rank p = 0.429), and no statistically difference was found in terms of alleviation of portal vein thrombosis (PVT). In addition, splenectomy (HR 19, 95% CI 4–90, p < 0.001) was identified as independent predictor of PVT. TIPS placement is well-founded to be considered as a safe and effective treatment in patients with schistosomiasis-induced portal hypertension and relevant severe complications. We also found the risk of PVT is 19 times higher in patients who underwent splenectomy than in untreated patients. Historically controlled studies, level 4.

This study aims to evaluate and compare the survival and other portal hypertension‐related complications of patients with portal pressure gradient (PPG) ≥ 25 mmHg using transjugular intrahepatic portosystemic shunt (TIPS) as the first‐line and second‐line therapies in secondary prophylaxis of variceal hemorrhage.

Objective: To evaluate the efficacy and safety of portal vein stenting combined with 125I particle strand implantation followed by drug-eluting beads transarterial chemoembolization (DEB-TACE) and molecular-targeted therapy for the treatment of stageⅢa liv-er cancer lacking a blood supply. Methods: A retrospective analysis of 11 patients who had stageⅢa liver cancer lacking a blood sup-ply combined with portal vein tumor thrombosis (PVTT) was conducted from October 2016 to October 2018. All the patients under-went portal vein stenting combined with 125I particle strand implantation, DEB-TACE, and comprehensive treatment containing molecu-lar-targeted drugs. During the follow-up period, all patients were evaluated for stent patency after the implantation and tumor re-sponse after DEB-TACE treatment. The liver function and blood routine changes before and 1 month after the surgery were completed, and the complications were summarized. Results: All 11 patients were judged as stageⅢa liver cancer based on the Chinese staging criteria (2017), Child-Pugh classification grade A and B. The imaging findings indicated that these tumors were hypovascular. The maxi-mum diameter of these lesions was (8.4±4.1) (2.8-14.1) cm, and all patients had PVTT. Among them, there were 4 cases of Cheng's typeⅡand 7 cases of typeⅢ: 6 cases of main PVTT≥50% and 1 case of PVTT<50%. All patients underwent portal vein stenting com-bined with 125I particle strand implantation, DEB-TACE, and comprehensive treatment containing molecular-targeted drugs. Three and 6 months after stent implantation, the patency rate was 100%; 3 months after DEB-TACE treatment, complete response was achieved in 4 (36.4%) patients, partial response was achieved in 5 (45.5%) patients, and stable disease was achieved in 2 (18.2%) patients. No patients exhibited progressive disease. Therefore, the objective response rate was 81.8% and disease control rate was 100%. As for the liver and kidney function and blood routine tests, there were no significant differences between baseline and 1 month after the sur- gery. In addition, no patient had any serious complication during the perioperative period. Conclusions: For patients with stageⅢa liv-er cancer lacking a blood supply and PVTT, a comprehensive treatment strategy including portal vein stenting combined with 125I parti-cle strand implantation, DEB-TACE, and molecular-targeted therapy can restore portal vein blood flow and maintain mid-and long-term stent patency, while effectively killing tumors and controlling tumor growth, which is a safe and effective treatment strategy.

Background To determine the safety and efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (hereafter, TACE-RFA) in treating Barcelona Clinic Liver Cancer (BCLC) Stage A or B (hereafter, BCLC A/B) hepatocellular carcinoma (HCC) patients, and to explore the range of tumor sizes suitable for combination therapy. Methods This retrospective study assessed the consecutive medical records of HCC patients with BCLC A/B who received TACE-RFA or TACE from September 2009 to September 2018. Progression-free survival (PFS), overall survival (OS), therapeutic response, and complications were compared between the two groups. Results Among 2447 patients who received TACE-RFA or TACE, 399 eligible patients were enrolled in our study, including 128 patients in the TACE-RFA group and 271 patients in the TACE group. Compared with the TACE group, the PFS and OS rates of 1,3,5,8 years in the TACE-RFA group were significantly better, with higher objective tumor regression rate and better disease control rate. RFA treatment did not increase the risk of death in patients with HCC, and both liver subcapsular hematoma and bile duct injury were improved by symptomatic treatment.. Serum α-fetoprotein level and treatment method were important independent prognostic factors for OS, whereas albumin, hepatitis B and treatment method were important independent prognostic factors for PFS. Subgroup analysis showed that patients in the TACE-RFA group always showed better OS and PFS. Conclusions TACE-RFA had an advantage over TACE alone in prolonging PFS and improving OS in HCC patients with BCLC A/B, and can benefit patients regardless of tumor size.

Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels.Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients.After placing the guide wire and the loop of the gooseneck snare on each side of the tubes,the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure.The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire.We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends.Results: With in situ formation of the loop snare technique,the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min.There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium.Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels.Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.

目的 观察比较经皮肝穿刺胃曲张静脉栓塞术(PTVE)联合或不联合部分脾动脉栓塞术(PSE)治疗急性食管胃底曲张静脉破裂出血的临床效果及预后.方法 回顾性分析2010年1月至2017年1月采用单纯PTVE或PTVE联合PSE治疗的56例急性活动性食管胃底曲张静脉破裂出血患者临床资料,其中PTVE组22例、PTVE联合PSE组34例.结果 术后所有患者活动性上消化道出血完全停止.PTVE联合PSE组白细胞、血小板水平升高显著高于PTVE组(P=0.002,P=0.032).Log-Rank分析表明两组无事件生存时间(EFS)差异无统计学意义(x2=1.571,P=0.210),Cox回归分析表明Child-Pugh评分与再发出血显著相关(HR=1.296,95％CI=1.130～1.488,P＜0.001).结论 PTVE及PTVE联合PSE两种介入手术均可有效地治疗食管胃底曲张静脉破裂活动性出血,两者远期出血率差异无统计学意义,但PTVE联合PSE可显著改善患者脾功能亢进表现.Child-Pugh评分增高是术后再发出血的危险因素.

Objective To evaluate the clinical application of prophylactic uterine artery chemoembolization (UACE) together with sequential ultrasound-guided curettage of uterine cavity for the treatment of cesarean scar pregnancy (CSP). Methods The clinical data and follow-up results of 231 CSP patients who were treated with UACE together with sequential ultrasound-guided curettage of uterine cavity were retrospectively analyzed. Results After UACE together with sequential ultrasound-guided curettage of uterine cavity, successful termination of pregnancy was achieved in all 231 patients, neither hemorrhagic shock nor death occurred. The median amount of blood loss during curettage of uterine cavity was 10 ml. After curettage of uterine cavity, the median values of RBC, HGB and HCT were 3.53×1012/L, 105 g/L and 32％ respectively, the preoperative median values of which were 4.04×1012/L, 121 g/L and 36％ respectively, indicating there were a slight reduction in RBC, HGB and HCT after UACE, the differences were statistically significant (P＜0.001). The median values of β-HCG measured before UACE and after curettage of uterine cavity were29 069.0 U/ml and 1723.5 U/ml respectively, the difference was statistically significant (P＜0.001). According to the gestational age, the patients were divided into group A (gestational age ≤56 days) and group B (gestational age 57-81 days). Further stratified analysis showed that no statistically significant differences in blood loss during curettage of uterine cavity and in reduction degree of RBC, HGB and HCT after UACE existed between group A and group B. Conclusion Prophylactic UACE before CSP can effectively reduce the occurrence of massive bleeding during uterine curettage. For the treatment of CSP, UACE together with sequential ultrasound-guided curettage of uterine cavity is safe and reliable. Therefore, this therapy can be used as a routine treatment strategy for CSP.

OBJECTIVES:To evaluate the characteristics of Bletilla striata microspheres (BSMs) and its effects as an embolic agent in a rabbit model. METHODS:BSMs were prepared with an emulsification-cool condensation-chemical cross-linking method. The characteristics of BSMs in vitro were observed. Embolization experiments were performed in renal artery of rabbit and in a rabbit liver VX2 carcinoma model. Seventy-two New Zealand rabbits were divided into 2 groups, and the right renal artery was embolized with BSMs (200 μm in diameter) in the experimental group and with polyvinyl alcohol (PVA) of the same size in the control group. The pathological findings were examined with hematoxylin-eosin and Masson stainings. Liver and renal functions were tested before and after embolization. VX2 tumor was transplanted in 15 New Zealand rabbits, which were randomly divided into 3 groups (n=5). Group A were treated with saline, group B with a mixture of doxorubicin and lipiodol, and group C with hepatic arterial infusion of BSMs (200 μm in diameter). Tumor growth rate was evaluated by magnetic resonance imaging scan. Apoptosis-related factors (bax, bcl-2) and tumor vascular endothelial cell growth factor (VEGF) were evaluated through immunohistochemical staining. RESULTS:The characteristics of BSMs in vitro were in full compliance with the requirements for use in interventional procedures. In the renal artery embolization experiment, after BSMs intervention, it was more difficult to form collateral circulation than that with PVAs, and the kidney manifested atrophy and calcification. There were no significant difference of liver and renal functions in rabbits between groups. In the liver VX2 carcinoma embolization experiment, compared with group A, the growth rate of VX2 liver tumor and Bcl-2 levels was reduced, while apoptosis index, Bax, and VEGF were increased in group B (P<0.05). There were no significant difference between groups B and C (P>0.05). CONCLUSIONS:The characteristics of BSMs in vitro and in vivo meet the requirements for its use as an embolic agent in interventional approaches.

Objective To evaluate the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in treating Standford type B thoracic aortic dissection complicated by type A intramural hematoma.Methods From October 2015 to January 2017,a total of 3 patients with Standford type B thoracic aortic dissection complicated by type A intramural hematoma were admitted to authors' hospital to receive treatment.After admission,conservative treatment such as stabilizing blood pressure and heart rate,symptomatic medication,etc.were carried out for 14 days,then,TEVAR was performed.Results Successful TEVAR was accomplished in all 3 patients,no serious complications,such as reverse tear,occurred.One month after TEVAR,reexamination of total aortic CT angiography revealed that the rupture of dissection was completely closed with no internal leakage,the blood flow in the true lumen was obviously improved,the intramural hematoma was remarkably absorbed and faded away,and the wall thickness of ascending aorta returned to normal range.The clinical symptoms were greatly improved,no serious complications such as paraplegia or death occurred.Conclusion For the treatment of Standford type B thoracic aortic dissection complicated by type A intramural hematoma,TEVAR performed at 14 days after the onset of disease is safe and effective if the ascending aorta intima is intact and the clinical symptoms are relived after medication of lowering blood pressure and heart rate.

目的探讨颈动脉狭窄的术前准确诊断及支架置入术的安全性、有效性。方法搜集59例行颈动脉狭窄支架置入术患者的临床及影像资料,术前均行颈动脉超声检查,38例术前行颈动脉CTA检查,31例术前行MRA检查;共置入支架65枚,54例患者术中使用脑保护伞。结果术前CTA、MRA检查结果与术中DSA基本一致。59例均成功行支架置入术,其中1例术后出现肢体活动障碍、肌力减退,经对症治疗后恢复;所有患者均顺利出院。结论术前结合超声、CTA、MRA等检查,可对颈动脉狭窄程度与斑块性质进行准确评估;颈动脉支架置入术治疗颈动脉狭窄疗效确切,其安全性和有效性高。

The biological behaviors of residual hepatoma cells after transarterial embolization therapy, which exist in a hypoxic or even anaerobic tumor microenvironment, differ from the tumor cells under normoxic conditions. This study aimed to use a phage display peptide library for in vivo and in vitro screening to obtain a peptide which could specifically bind to hypoxic hepatoma cells, allowing further targeted diagnosis and treatment for liver cancer. In this study, hypoxic hepatoma cells HepG2 (targeted cells), and normal liver cells HL-7702 (control cells), were utilized to perform three rounds of in vitro screening using a phage-displayed 7-mer peptide library. In addition, hypoxic HepG2 were subcutaneously injected into nude mice to establish a hepatocarcinoma model, followed by performing three rounds of in vivo screening on the phages identified from the in vitro screening. The products from the screening were further identified using ELISA and immunofluorescence staining on cells and tissues. The results indicated that the P11 positive clone had the highest binding effect with hypoxic hepatoma cells. The sequence of the exogenous insert fragment of P11 positive clone was obtained by sequencing: GSTSFSK. The binding assay indicated that GSTSFSK could specifically bind to hypoxic hepatoma cells and hepatocarcinoma tissues. This 7-mer peptide has the potential to be developed as an useful molecular to the targeting diagnosis and treatment of residual hepatoma cells after transarterial chemoembolization.

目的:研究白介素12(interleukin 12,IL-12)基因治疗对介入栓塞后兔VX2肝癌模型的肿瘤微血管,以及对免疫微环境的影响,探讨IL-12抗肿瘤作用的机制.方法:成功建立VX2移植性肝癌模型的新西兰兔随机分为4组,每组8只,1组为对照组,经动脉灌注生理盐水,2组行肝动脉碘油化疗栓塞(超液态碘油+丝裂霉素),3组经肝动脉灌注治疗基因(编码AIL-12的重组基因),4组行肝动脉内碘油化疗栓塞+经肝动脉灌注治疗基因(超液态碘油+丝裂霉素+肝动脉内灌注编码人IL-12的重组基因).于治疗后第14天处死所有实验兔,免疫组织化学法检测肿瘤组织微血管密度值与CD3+、CD4+、CD8+效应性T细胞,以及FoxP3+调节性T细胞.结果:化疗栓塞组肿瘤微血管密度、FoxP3+ 细胞明显高于对照组,CD3+、CD4+、CD8+T细胞与对照组之间无明显差异(P＞0.05).IL-12基因治疗后肿瘤微血管密度明显低于化疗栓塞组与对照组,而CD3+、CD4+、CD8+T细胞高于化疗栓塞组与对照组,两个基因治疗组(3组与4组)之间无明显差异.IL-12基因治疗后,FoxP3+细胞变化不明显,3组与1组之间差异、4组与2组之间差异无统计学意义.结论:IL-12基因治疗可以抑制肿瘤血管生成,并且诱导CD3+、CD4+、CD8+效应性T细胞浸润,但存在于肿瘤中以及化疗栓塞后高表达的FoxP3+调节性T细胞可能会限制IL-12的抗肿瘤作用.

Transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) has been reported to be effective for local control of different-sized hepatocellular carcinomas. However, it is unclear if these benefits could also be applicable to different-sized liver metastases from gastrointestinal cancers. The aim of this study was to evaluate the outcomes of TACE combined with RFA for liver metastases from gastrointestinal cancers. In this study, we retrospectively analyzed clinical data of 19 consecutive patients who had a total of 26 liver metastatic lesions from gastrointestinal cancers and underwent RFA followed by first-time TACE treatment. The tumor recurrence, overall survival rate and procedure-related complications were evaluated. Moreover, patients' demographics and tumor characteristics were analyzed to determine their impact on the outcomes. The technical success of TACE plus RFA was achieved with 2 major procedure-related complications found. The mean follow-up was 21.3 months. The total 1-, 2-, and 3-year survival rate was 89.4%, 52.6%, and 35.1%, respectively. It was found that the tumor size and the ratio of enhancement area were significant factors that influenced the overall survival. In conclusion, patients with gastrointestinal cancer-derived liver metastatic lesions of smaller size and larger enhancement area are considered appropriate candidates for TACE plus RFA.