A randomized phase II/III trial of three weekly cisplatin based transarterial chemoembolization (TACE) versus embolization (TAE) alone for hepatocellular cancer (HCC).

Transarterial embolization as neo‐adjuvant therapy pretransplantation in patients with hepatocellular carcinoma

“…Despite current recommendations on the preferential use of TACE over TAE (9,24), we have shown and commented that the two treatment modalities have no significant differences in efficacy (6,14,21,25). Indeed, in a published metaanalysis TACE was not superior to TAE (14), whereas two additional RCTs conducted since have shown no difference in efficacy between the two modalities (17,26). The TACE technique consists of selective chemotherapy infusion, immediately followed by occlusion of the tumour vessel.…”

“…The presence of microvascular and microvascular invasion and smaller PVA particles (45–150 μm) were the only factors significantly associated with a favourable response to TA(C)E, as the histological grade, the number or size of lesions, number of TAE sessions, age of patient, Child‐Pugh score and aetiology of liver disease were not associated. Importantly, there was no difference in terms of histological response between patients who had TAE and those who had TACE (no/partial/complete necrosis 1/6/2 vs. 1/4/4, P = NS, data from randomized controlled trial ). Of 67 patients who had transarterial treatment, 5 (7.5%) had an HCC recurrence in mean 40 ± 21 months.…”

“…In our unit percutaneous treatments such as radiofrequency ablation are not routinely used in the pre‐LT setting because of the small, but not negligible risk, of tumour seeding . A subset of patients was randomized to transarterial chemoembolization between 2003 and 2010, as part of a clinical trial . Eighteen patients who were eventually transplanted were randomized, nine being allocated in the TACE (with cisplatin) and nine in the TAE group respectively.…”

“…Eighteen patients who were eventually transplanted were randomized, nine being allocated in the TACE (with cisplatin) and nine in the TAE group respectively. In the trial no significant difference in survival between the two therapies was demonstrated, with an overall survival of 16.2 months vs. 15.9 months in patients who had TAE and TACE respectively . Polyvinyl alcohol particles (PVA) 100–500 μm was the embolizing agent used until 2005, and it was subsequently substituted with smaller diameter, 40–150 μm.…”

Heterogeneity of Patients with Intermediate (BCLC B) Hepatocellular Carcinoma: Proposal for a Subclassification to Facilitate Treatment Decisions

“…There is no convincing evidence for superiority of cTACE compared with embolization alone (TAE). 27 A randomized controlled trial comparing cTACE, TAE, and best supportive care was prematurely terminated due to the superiority of cTACE compared with best supportive care. 28 Unfortunately, this prevented the possibility to verify the superiority of TAE over best supportive care, which could be hypothesized based on the trend observed in overall survival.…”