Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma

Abstract

Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). In this review, we summarize recent updates on the use of TACE for HCC. TACE can be performed using two techniques; conventional TACE (cTACE) and drug-eluting beads using TACE (DEB-TACE). The anti-tumor effect of the two has been reported to be similar; however, DEB-TACE carries a higher risk of hepatic artery and biliary injuries and a relatively lower risk of post-procedural pain than cTACE. TACE can be used for early stage HCC if other curative treatments are not feasible or as a neoadjuvant treatment before liver transplantation. . TACE can also be considered for selected patients with limited portal vein thrombosis and preserved liver function. When deciding to repeat TACE, the ART (Assessment for Retreatment with TACE) score and ABCR (AFP, BCLC, Child-Pugh, and Response) score can guide the decision process, and TACE refractoriness needs to be considered. Studies on the combination therapy of TACE with other treatment modalities, such as local ablation, radiation therapy, or systemic therapy, have been actively conducted and are still ongoing. Recently, new prognostic models, including analysis of the neutrophil-lymphocyte ratio, radiomics, and deep learning, have been developed to help predict survival after TACE.

A Radiomics Signature-Based Nomogram to Predict the Progression-Free Survival of Patients With Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization Plus Radiofrequency Ablation

“…Local interventional strategies such as transarterial arterial chemoembolization (TACE), radiofrequency ablation (RFA) and radioactive particle implantation are widely used in the treatment of advanced HCC ( Makary et al, 2020 ). The combination of TACE and RFA therapy has a synergistic cytotoxic effect on HCC and results in better local tumour control and longer survival than TACE or RFA alone ( Peng et al, 2013 ; Shimose et al, 2019 ; Chang et al, 2020 ; Yuan et al, 2021 ).…”

Feasibility and safety of liver resection for huge hepatocellular carcinoma in cirrhotics

“…[19][20][21] However, in the context of huge HCC in the cirrhotic liver, treatment options include liver resection, TACE, TARE and targeted therapy. [22][23][24][25] The current literature showed that in carefully selected patients with huge HCC would benefit from liver resection as upfront treatment approach. 10,[26][27][28] Likewise, several comparative studies documented the superiority of liver resection for huge HCC compared with TACE regarding overall and recurrence-free survival.…”

Factors Associated with Recurrence of Hepatocellular Carcinoma in 197 Patients Following Transarterial Chemoembolization: A Retrospective Study from a Single Center

“…Inflammation has been found to play an important role in the pathogenesis and progression of malignant tumors. As a marker of systemic inflammation, NLR is associated with cancer progression, metastasis, and prognosis in various cancers, including HCC [ 19 ]. In our study, the risk of developing postoperative recurrence increased with the rise in NLR.…”