Chemoembolization of Hepatocellular Carcinoma

Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for patients with unresectable hepatocellular carcinoma (HCC). Chemoembolization involves delivery of some type of chemotherapy combined with some type of arterial embolization to destroy tumor cells. Whereas diffuse tumors...

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Bibliographic Details
Published inJournal of vascular and interventional radiology Vol. 13; no. 9; pp. S211 - S221
Main Authors Ramsey, Douglas E., Kernagis, Lily Y., Soulen, Michael C., Geschwind, Jean-Francois H.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.09.2002
Subjects
Antineoplastic Agents - administration & dosage
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - therapy
Chemoembolization, Therapeutic
Humans
Liver Neoplasms - diagnosis
Liver Neoplasms - therapy
Liver neoplasms, chemotherapeutic infusion
Liver neoplasms, therapeutic radiology
Neoadjuvant Therapy
Prognosis
Radiography, Interventional
Treatment Outcome
Liver neoplasms, therapeutic radiology
RCT
Liver neoplasms, chemotherapeutic infusion
PEI
TACE
HCC
TAE
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Summary:Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for patients with unresectable hepatocellular carcinoma (HCC). Chemoembolization involves delivery of some type of chemotherapy combined with some type of arterial embolization to destroy tumor cells. Whereas diffuse tumors may require lobar embolization, smaller tumors may be treated selectively. The goal of TACE is to cause tumor necrosis and control tumor growth while preserving as much functional liver tissue as possible. The ultimate purpose, however, is to prolong life. Several different TACE protocols have been developed, with no consensus as to the most effective techniques. The effect of TACE on patient survival remains unclear. Several nonrandomized studies have demonstrated a beneficial effect of TACE on survival. This result has not been confirmed with randomized trials. It is clear, however, that TACE is a palliative procedure that has been unable to provide a cure for HCC. When combined with other procedures such as percutaneous ethanol injection, TACE has been more successful at achieving survival rates matching those obtained after surgical resection in similar patient populations. Finally, TACE may also be useful as a neoadjuvant therapy by improving the outcomes of potentially curative therapies and as a bridge to liver transplantation.
ISSN:1051-0443
1535-7732
DOI:10.1016/S1051-0443(07)61789-8