Hepatocellular carcinoma is the third most common cause of cancer-related mortality. In recent years, transarterial chemoembolization, radio frequency ablation and microwave ablation have been accepted as treatment modalities for patients with surgically unresectable hepatocellular carcinoma.

To compare between combination treatment with radiofrequency or microwave ablation followed by transarterial chemoembolization and performed in a single session.

Inclusion Criteria:

• Child classification A or B.
• serum albumin ≥ 3 gm/L.
• serum bilirubin < 2.5 mg/dL.
• platelet count ≥70,000 mm3.
• INR ≤ 1.6.
• serum creatinine < 2 mg/dl.
• tumor size more than 4 cm and confined to one lobe of the liver.

Exclusion Criteria:

• Patients with portal vein thrombosis.
• A technically inaccessible hepatic artery.
• Metastatic HCC.
• More than three lesions.
• lesions in close proximity to the portal vein (PV),inferior vena cava (IVC) or gall bladder were excluded from the study.