Primary liver cancer is one of the most common malignant tumors in the world, especially in China, which is characterized by rapid disease progression, short disease duration, high death rate, and insidious disease in the early stage, all of which make treatment difficult. Currently, surgical resection is still the recognized radical treatment method for primary liver cancer. However, the five-year survival rate of patients after surgery is only 25%-39%. However, due to the insidious disease in the early stage, once clinical symptoms appear, they are already in the middle to late stage and lose the opportunity of surgery. These reasons include: 1) multiple foci and adverse biological behavior of multiple tumors; 2) large lesions and close proximity to large blood vessels and bile ducts that cannot be resected effectively; 3) combined cirrhosis resulting in liver function that cannot tolerate surgery. Trans catheter arterial chemo embolization (TACE) is widely used in clinical practice as an effective treatment for hepatocellular carcinoma [2,3], which can effectively prolong the survival of patients with primary hepatocellular carcinoma and inhibit tumor recurrence after surgery. In addition to vascular intervention, there are still many treatment methods for liver cancer, such as percutaneous anhydrous alcohol injection (PEI), laser-induced interstitial thermotherapy (LITT), iodine 125 intertissue radiotherapy, percutaneous argon helium knife, local thermal ablation techniques such as percutaneous radiofrequency ablation (RFA) and microwave thermocoagulation (PMC). Each of these treatment methods has its own advantages and disadvantages, and with the advancement of research and technology, great progress has been made in the efficacy of various treatment methods. However, the effect of any single treatment method is limited. Therefore, there is a consensus that the overall efficacy of hepatocellular carcinoma depends on the combination of multiple methods. 1.Trans catheter arterial chemo embolization (TACE): TACE is one of the main treatment methods for hepatocellular carcinoma at present. TACE is one of the main methods for the treatment of hepatocellular carcinoma. It mainly embolizes the blood supplying artery of the tumor to cause necrosis of the tumor, and at the same time, the slow release of anti-tumor drugs in the tumor area plays the role of chemotherapy. In addition, studies at home and abroad have shown that for small hepatocellular carcinoma, there is no significant difference in efficacy between TACE treatment and surgical resection, and it is also the preferred method for small hepatocellular carcinoma treatment because of the characteristics of less damage and faster recovery [6]. However, the high recurrence rate and poor long-term efficacy of TACE alone are due to multiple anatomical variants of the hepatic artery, multiple sources of blood supply to the liver and portal vein, multiple blood supply to the tumor tissue, formation of collateral circulation, and the flushing effect of blood flow on the deposited embolic agent, etc. Testa et al. reported that only 20%-50% of tumors showed complete necrosis after TACE alone [7]. The rate of complete necrosis reported in China is even lower [8]. Local thermal ablation therapy: including radiofrequency ablation (RFA) and percutaneous micro wave coagulation therapy (PMCT), which is mainly aimed at the characteristics of tumor cells that are not heat resistant, using physical methods to locally heat the tumor tissue to make it coagulate and necrosis. PMCT and RFA produce localized high temperature of 60°C-100°C or more inside the tumor in a short period of time through the thermal effects of electromagnetic waves and high-frequency currents, respectively, to cause tumor necrosis. The mechanisms of action are [9]: 1), stasis and hypoxia of tumor tissues; 2), decrease in PH value, increase in acidity, increase in lysosomes and sexualization of lysosomal enzymes in tumor tissues; 3), inhibition of DNA, RNA and protein synthesis in tumor cells by high temperature; 4), enhancement of the body’s immune response.Choi et al. reported that it has a high near-term survival rate [10]. Local thermal ablation combined with TACE for hepatocellular carcinoma can complement each other’s strengths and thus increase the efficacy. kitamoto [11] et al. compared the tumor ablation area of RFA alone and in combination with TACE and confirmed that the latter was significantly greater than the former. After TACE, due to the effect of chemotherapy drugs and embolic agents, the blood supply to the tumor is blocked, which makes the tumor area considerably reduced and the boundary is clear, creating favorable conditions for thermal ablation therapy; TACE increases the “hearth effect” of the lesion and reduces the “cooling effect” of the flowing blood. In addition, the high temperature after thermal ablation treatment can also improve the killing effect of chemotherapeutic drugs on tumor cells after TACE. Therefore, TACE combined with thermal ablation for primary liver cancer is a more studied method. Comparison between microwave coagulation therapy (PMCT) and radiofrequency ablation (RFA): The inactivation of tumor by radiofrequency ablation (RFA) therapy has been widely recognized, and the comprehensive domestic and foreign studies have concluded that RFA can make 50%-70% of 5-cm diameter masses with less than 50% complete necrosis rate [13,14]. The main reasons are that the therapeutic effect of RFA for hepatocellular carcinoma is positively correlated with its ablation range of tumor tissues. The effective diameter range of monopolar RF needle is only 1.6 cm, and the effective diameter range of multipolar umbrella needle is only about 5 cm, and it requires the deployment of electrode needle in the tumor, which is complicated and has potential surgical risks and corresponding complications, thus making the operator more conservative in the implementation and affecting the treatment range. The cold circulation microwave technology currently used confines the temperature production to the antenna head end, which completely solves the thermal damage to the surrounding tissues by the microwave antenna rod and improves the safety of the surgery. The use of dual-blade head can further expand the scope of destruction and improve the one-time in situ inactivation rate; in addition, after TACE, a fractionated coagulation method can be adopted according to the confined lesion scope to achieve the required scope of destruction, and peripheral closure can be implemented for residual tumor vessels, thus improving the efficacy [15]. Moreover, the current microwave knives are automatically controlled by microcomputer, and the treatment process can automatically adjust the output resistance, current, and power, which simplifies the operation, improves the safety of the procedure, reduces the risk, and improves the efficacy. Meanwhile, domestic studies have shown [16] that the CD4/CD8 ratio of cellular immune index of liver cancer cured by microwave has increased significantly after one week, indicating that microwave knife treatment also has the effect of improving the immune ability of the body, so microwave knife has unique advantages over RF ablation.TACE combined with microwave knife for liver cancer treatment can play their unique advantages, and the tumor tissue and surrounding Tissue blood supply is reduced, thus reducing the loss of local heat due to blood flow; the ischemia and inflammatory reaction caused after TACE, etc. lead to edema of tumor and surrounding tissues, which increases the microwave knife treatment is the accumulation of energy and increases the volume of tumor necrosis. A domestic study [17] showed that the tumor necrosis rate and one-year survival rate of TACE combined with microwave knife treatment for liver cancer were 83.9% and 80.6%, respectively, which were significantly improved compared with either TACE or microwave knife treatment alone. Therefore, for patients with primary hepatocellular carcinoma, early diagnosis and early and reasonable treatment are especially important, and the combined use of various therapeutic methods to complement each other’s strengths and give full play to their respective advantages, as well as the patient’s own confidence in overcoming the disease, good attitude and living habits, will certainly lead to satisfactory results. Therefore, tumor is not invincible. Therefore, tumor is not invincible.