Transcatheter Chemoembolization of Unresectable Hepatocellular Carcinoma: Current Knowledge and Future Directions

Abstract

Transarterial chemoembolization (TACE) is considered the gold standard for the treatment of unresectable hepatocellular carcinoma (HCC) in patients with a preserved liver function and in the absence of clear extrahepatic tumor spread. This review article deals with the radiological and clinical workup, the interventional technique of chemoembolization for HCC and gives an overview of the common as well as some rare and dramatic complications of TACE. Finally, some new trends and advances in clinical research with regard to the interventional management of HCC are discussed.

A Randomized Phase II Study of Drug-Eluting Beads versus Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma

“…The technique is based on the predominantly hepatic artery blood supply of HCC; when selective intra-arterial injection of a cytotoxic agent is performed, high concentrations can be obtained within the tumor [27]. In the conventional procedure, lipiodol is added to improve uptake of the chemotherapeutic agent within the tumor and to reduce systemic side effects [28].…”

Bridging and downstaging therapy in patients suffering from hepatocellular carcinoma waiting on the list of liver transplantation

“…Patients who suffered from ascites and main portal vein thrombosis resulted from cirrhosis, poor liver function at risk of liver failure, poor renal function at risk of contrast nephropathy, difficult arterial anatomy and difficult cannulation are contraindication from TACE (38,55). These patients are at risk of tumor progression without any intervention.…”

Gastrointestinale Angiographie

“…Bei der transarteriellen Chemoembolisation (TACE) handelt es sich um ein minimalinvasives Verfahren zur palliativen Therapie primärer und sekundärer, arteriell hypervaskularisierter Lebermalignome, bei dem Zytostatika in Kombination mit embolisierenden Substanzen in das arterielle Lebergefäßbett injiziert werden [4]. Zur Planung einer TACE ist präinterventi-onell eine dynamische, kontrastmittelverstärkte CT oder MRT der Leber erforderlich, um Informationen über den arteriellen Zugangsweg, akzessorische, leberversorgende Arterien und arterielle Normvarianten zu gewinnen und Kontraindikationen wie eine Pfortaderthrombose zu erkennen.…”