ObjectiveTo modify the strategy and methodology of percutaneous microwave ablation for treatment of hepatocellular carcinoma (HCC), so as to simplify the therapeutic process and improve the therapeutic effect. MethodsA total of 92 HCC patients with 149 nodes, with an average diameter of (4.9±3.4) cm, were treated by the newly designed cooling circulation microwave electrode. Continuous ablation was used for tumors with diameters less than 6 cm and ring-shaped continuous ablation was applied for tumors with diameters more than 6 cm. Microwave ablation was used to treat tumors with diameters less than 4 cm. For tumors with diameters more than 4 cm, transcatheter arterial chemoembolization (TACE) was used before microwave ablation and nutrient arteries were given priority for ablation. Ring-shaped continuous ablation strategy and double antenna ablation strategy were adopted for tumors over 6 cm. Enhanced CT scans were performed at regular intervals to evaluate the therapeutic effect and the one-, two- and three-year survival rates were observed. Results(1) The complete necrosis rates for once, twice, and multiple ablations were 76.5%(114/149), 86.6%(129/149) and 95.3%(142/149), respectively. (2) The one-, two- and three-year survival rates in our group were 94.6%(87/92), 72.9%(62/85) and 61.4% (35/57), respectively. ConclusionSingle microwave ablation is effective for small HCC. Double antenna ablation + first ablation of nutrient artery + TACE was effective for huge HCC. Ring-shaped continuous ablation strategy can greatly reduce ablation points and simplify the ablation process, which is probably a new way for in situ complete necrosis of huge HCC.