Internal medicine

Radiology

Regorafenib

Milan criteria

Hepatocellular carcinoma

Colorectal cancer

Biology

Gastroenterology

Cancer

Oncology

Stage (stratigraphy)

Paleontology

Chemotherapy

Portal vein thrombosis

Progressive disease

Ablation

Radiofrequency ablation

Thrombosis

Liver transplantation

Liver function

Response Evaluation Criteria in Solid Tumors

Transplantation

Medicine

International Journal of Molecular Sciences

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.

Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma