Transarterial Chemoembolization and Unresectable Hepatocellular Carcinoma: A Narrative Review

Manjunatha, Nisha; Ganduri, Vinutna; Rajasekaran, Kruthiga; Duraiyarasan, Shrimahitha; Adefuye, Mayowa

doi:10.7759/cureus.28439

Cited by 11 publications

(12 citation statements)

References 74 publications

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“…TACE is considered to cause tumor necrosis by creating a hypoxic environment and producing cytotoxic effects on tumor cells by concentrating high doses of chemotherapy drugs locally on the tumor ( 28 ). TACE can improve the quality of life and extend the survival of patients in intermediate or advanced HCC stages ( 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of preoperative serum ferritin in hepatocellular carcinoma patients undergoing transarterial chemoembolization

Fan,

Niu,

Lin

et al. 2024

Mol Clin Oncol

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The present study investigated the prognostic impact of preoperative serum ferritin (SF) levels on the survival of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). Clinicopathological characteristics and laboratory biomarkers of 223 patients with HCC who underwent TACE were retrospectively reviewed. The Kaplan-Meier method was used to calculate the overall survival (OS), and the log-rank test was used to evaluate statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazards regression to evaluate the prognostic impact of SF in these patients. The present findings identified extrahepatic metastases [hazard ratio (HR)=0.490,95%; confidence interval (CI)=0.282-0.843; P=0.010)] and vascular invasion (HR=0.373; 95% CI=0.225-0.619; P<0.0001) as independent prognostic factors for OS. However, preoperative SF levels could not independently predict OS when compared with other prognostic factors (HR=0.810; 95% CI=0.539-1.216; P=0.309). In conclusion, preoperative SF level is an unreliable biochemical predictor of survival in patients with HCC undergoing TACE.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of preoperative serum ferritin in hepatocellular carcinoma patients undergoing transarterial chemoembolization

Fan,

Niu,

Lin

et al. 2024

Mol Clin Oncol

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“…With the continuous application of combined technology in clinical application, TACE combined with TARE technology has better efficacy in patients with mid or advanced HCC[ 8 , 10 ]. Since Goldstein first reported the treatment of HCC with TACE in 1976, TACE has been rapidly developed and further developed worldwide[ 11 , 28 ]. TACE is mainly suitable for patients with unresectable HCC and well liver function, and its efficacy is positive, which can improve the survival rate of HCC patients in this stage[ 2 , 29 - 31 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety analysis of transarterial chemoembolization and transarterial radioembolization in advanced hepatocellular carcinoma descending hepatectomy

Feng¹,

Cheng²,

Song³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, which is seriously threatening the lives of patients. Due to the rapid development of the disease, patients were in the middle and advanced stages at the time of diagnosis and missed the best time for treatment. With the development of minimally invasive medicine, interventional therapy for advanced HCC has achieved promising results. Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are currently recognized as effective treatments. This study aimed to investigate the clinical value and safety of TACE alone and combined with TACE in the treatment of progression in patients with advanced HCC and to find a breakthrough for the early diagnosis and treatment of patients with advanced HCC. AIM To investigate the efficacy and safety of hepatic TACE and TARE in advanced descending hepatectomy. METHODS In this study, 218 patients with advanced HCC who were treated in the Zhejiang Provincial People’s Hospital from May 2016 to May 2021 were collected. Of the patients, 119 served as the control group and received hepatic TACE, 99 served as the observation group and were treated with hepatic TACE combined with TARE. The patients in two groups were compared in terms of lesion inactivation, tumor nodule size, lipiodol deposition, serum alpha-fetoprotein (AFP) level in different periods, postoperative complications, 1-year survival rate, and clinical symptoms such as liver pain, fatigue, and abdominal distension, and adverse reactions such as nausea and vomiting. RESULTS The observation group and the control group had good efficacy in treatment efficiency, reduction of tumor nodules, reduction of postoperative AFP value, reduction of postoperative complications, and relief of clinical symptoms. In addition, compared with the control group, the treatment efficiency, reduction of tumor nodules, reduction of AFP value, reduction of postoperative complications, and relief of clinical symptoms in the observation group were better than those in the TACE group alone. Patients in the TACE + TARE group had a higher 1-year survival rate after surgery, lipiodol deposition was significantly increased and the extent of tumor necrosis was expanded. The overall incidence of adverse reactions in the TACE + TARE group was lower than that in the TACE group, and the difference had statistical significance ( P < 0.05). CONCLUSION Compared with TACE alone, TACE combined with TARE is more effective in the treatment of patients with advanced HCC. It also improves postoperative survival rate, reduces adverse effects, and has a better safety profile.

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“…The Barcelona Clinic Liver Cancer (BCLC) staging system is widely used to classify patients into very early (0), early (A), intermediate (B), advanced (C), and terminal (D) stages according to the progression stage and the patient’s performance status. Trans-arterial chemoembolization (TACE) is a local treatment method for inducing tumor necrosis by the anticancer effect of local retention of anticancer drugs and the inhibitory effect of embolization of tumor nutrient blood vessels, and cisplatin, doxorubicin, and epirubicin are often used, with cisplatin being the most commonly used for HCC [ 132 ]. Despite numerous reports showing the usefulness of cisplatin in TACE for HCC [ 133 , 134 , 135 , 136 ], no inference on the superiority of any particular drug has been made [ 137 ].…”

Section: Cisplatin For Hcc Treatmentmentioning

confidence: 99%

Cisplatin in Liver Cancer Therapy

Hamaya

Oura

Morishita

et al. 2023

IJMS

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Hepatocellular carcinoma (HCC) is the most common primary liver tumor and is often diagnosed at an unresectable advanced stage. Systemic chemotherapy as well as transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) are used to treat advanced HCC. TACE and HAIC have long been the standard of care for patients with unresectable HCC but are limited to the treatment of intrahepatic lesions. Systemic chemotherapy with doxorubicin or chemohormonal therapy with tamoxifen have also been considered, but neither has demonstrated survival benefits. In the treatment of unresectable advanced HCC, cisplatin is administered transhepatic arterially for local treatment. Subsequently, for cisplatin-refractory cases due to drug resistance, a shift to systemic therapy with a different mechanism of action is expected to produce new antitumor effects. Cisplatin is also used for the treatment of liver tumors other than HCC. This review summarizes the action and resistance mechanism of cisplatin and describes the treatment of the major hepatobiliary cancers for which cisplatin is used as an anticancer agent, with a focus on HCC.

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Transarterial Chemoembolization and Unresectable Hepatocellular Carcinoma: A Narrative Review

Cited by 11 publications

References 74 publications

Prognostic value of preoperative serum ferritin in hepatocellular carcinoma patients undergoing transarterial chemoembolization

Prognostic value of preoperative serum ferritin in hepatocellular carcinoma patients undergoing transarterial chemoembolization

Efficacy and safety analysis of transarterial chemoembolization and transarterial radioembolization in advanced hepatocellular carcinoma descending hepatectomy

Cisplatin in Liver Cancer Therapy

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