Chemoembolization of hepatocellular carcinoma

Douglas E. Ramsey, Lily Y. Kemagis, Michael C. Soulen, Jean Francois H. Geschwind

Research output: Contribution to journalReview article

Abstract

Transcatheter arterial chemoembolization (TACE) is the mainstay of treatment for patients with unresectable hepatocellular carcinoma (HCC). Chemoembolization involves delivery of some type of chemotherapy combined with some type of arterial embolization to destroy tumor cells. Whereas diffuse tumors may require lobar embolization, smaller tumors may be treated selectively. The goal of TACE is to cause tumor necrosis and control tumor growth while preserving as much functional liver tissue as possible. The ultimate purpose, however, is to prolong life. Several different TACE protocols have been developed, with no consensus as to the most effective techniques. The effect of TACE on patient survival remains unclear. Several nonrandomized studies have demonstrated a beneficial effect of TACE on survival. This result has not been confirmed with randomized trials. It is clear, however, that TACE is a palliative procedure that has been unable to provide a cure for HCC. When combined with other procedures such as percutaneous ethanol injection, TACE has been more successful at achieving survival rates matching those obtained after surgical resection in similar patient populations. Finally, TACE may also be useful as a neoadjuvant therapy by improving the outcomes of potentially curative therapies and as a bridge to liver transplantation.

Original languageEnglish (US)
Pages (from-to)S211-S221
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number9 II
DOIs
StatePublished - Sep 1 2002

Keywords

  • Liver neoplasms, chemotherapeutic infusion
  • Liver neoplasms, therapeutic radiology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Ramsey, D. E., Kemagis, L. Y., Soulen, M. C., & Geschwind, J. F. H. (2002). Chemoembolization of hepatocellular carcinoma. Journal of Vascular and Interventional Radiology, 13(9 II), S211-S221. https://doi.org/10.1016/s1051-0443(07)61789-8