Objectives
To evaluate the management of advanced primary hepatocellular carcinoma (HCC) and hepatic metastatic disease with a protocol of combined transarterial chemoembolization (TACE) and percutaneous radiofrequency ablation (RFA) at a hepatobiliary center.

Materials and Methods
Between 2010-2013, patients with advanced HCC (stage IV) and cirrhosis, and with unresectable hepatic metastatic disease, were managed with a protocol of combined TACE and RFA, with several sessions. Demographic data, etiology and staging, as well as survival and RECIST criteria were examined. A total of 14 patients were treated. Nine with TACE, 3 with RFA and 2 with a combined approach.

Result
There were 10 male and 4 female patients, between 49 and 79 years old, divided in three subgroups <65 (2), 65-75 (6), 75-85 (6). Three of the patients have HCC due to Alcoholic cirrhosis, 6 due to HBV (1 along with cirrhosis), 1 due to HCV, 1 patient with intrahepatic cholangiocarcinoma, and 4 with metastatic hepatic disease. All of the patients, except one who passed away after 2 years of treatment, are alive. Patients were categorized in subgroups; according to MELD system: under 9 (9), between 10-19 (5), by Barcelona Clinic Liver Cancer staging system A1 (3), A4 (2), B (6), on follow up (3) and RECIST: No Response; (2), Partial Response (PR); (4), Progressive disease (PD); (2), Complete Response (CR); (2), on follow up (3) and unknown (2).

Conclusion
Through a combined approach using several sessions of TACE and RFA, respectable results are possible in patients with advanced hepatobiliary malignancies.