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Review
. 2022 Mar 10;12(3):436.
doi: 10.3390/jpm12030436.

Transarterial Chemoembolization for Hepatocellular Carcinoma: Why, When, How?

Evgenia Kotsifa  1 , Chrysovalantis Vergadis  2 , Michael Vailas  3 , Nikolaos Machairas  1 , Stylianos Kykalos  1 , Christos Damaskos  1 , Nikolaos Garmpis  1 , Georgios D Lianos  4 , Dimitrios Schizas  3
Affiliations
Review

Transarterial Chemoembolization for Hepatocellular Carcinoma: Why, When, How?

Evgenia Kotsifa et al. J Pers Med. .

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. It is principally associated with liver cirrhosis and chronic liver disease. The major risk factors for the development of HCC include viral infections (HBV, HCV), alcoholic liver disease (ALD,) and non-alcoholic fatty liver disease (NAFLD). The optimal treatment choice is dictated by multiple variables such as tumor burden, liver function, and patient's health status. Surgical resection, transplantation, ablation, transarterial chemoembolization (TACE), and systemic therapy are potentially useful treatment strategies. TACE is considered the first-line treatment for patients with intermediate stage HCC. The purpose of this review was to assess the indications, the optimal treatment schedule, the technical factors associated with TACE, and the overall application of TACE as a personalized treatment for HCC.

Keywords: cirrhosis; hepatocellular carcinoma; liverneoplasm; transarterial chemoembolization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Balloon-occluded transarterial chemoembolization technique. (a,b): superselective catheterization of the arterial branch feeding the tumor, (c): occlusion of feeding artery by infletion of a microballoon catheter and subsequent administration of chemotherapeutic regimen.
Figure 2
Figure 2
Proposed treatment algorithm regarding TACE in HCC patients. LT: Liver transplantation, TACE: transarterial chemoembolization, RFA: radiofrequency ablation, MWA: microwave ablation, * when in waiting list > 6 months, ‡ extended liver transplant criteria (size, AFP).
See this image and copyright information in PMC

References

    1. Forner A., Reig M., Bruix J. Hepatocellular carcinoma. Lancet. 2018;391:1301–1314. doi: 10.1016/S0140-6736(18)30010-2. - DOI - PubMed
    1. Ioannou G.N., Green P., Lowy E., Mun E.J., Berry K. Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis. PLoS ONE. 2018;13:e0204412. doi: 10.1371/journal.pone.0204412. - DOI - PMC - PubMed
    1. Frager S.Z., Schwartz J.M. Hepatocellular Carcinoma: Epidemiology, Screening, and Assessment of Hepatic Reserve. Curr. Oncol. 2020;27:138–143. doi: 10.3747/co.27.7181. - DOI - PMC - PubMed
    1. Reig M., Forner A., Rimola J., Ferrer-Fábrega J., Burrel M., Garcia-Criado A., Kelley R.K., Galle P.R., Mazzaferro V., Salem R., et al. BCLC strategy for prognosis prediction and treatment recommendation Barcelona Clinic Liver Cancer (BCLC) staging system. The 2022 update. J. Hepatol. 2021;76:681–693. doi: 10.1016/j.jhep.2021.11.018. - DOI - PMC - PubMed
    1. Llovet J.M., Brú C., Bruix J. Seminars in Liver Disease. Volume 19. Thieme Medical Publishers, Inc.; New York, NY, USA: 1999. Prognosis of hepatocellular carcinoma: The BCLC staging classification; pp. 329–338. - PubMed

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