[Transarterial chemoembolisation in hepatocellular carcinoma].

Area of Science:

• Hepatobiliary oncology
• Interventional radiology
• Medical oncology

Context:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide.
• Loco-regional therapies are crucial for managing HCC, offering alternatives to systemic treatments.
• Transarterial chemoembolization (TACE) has emerged as a significant therapeutic option.

Purpose:

• To provide a comprehensive overview of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
• To describe the dual mechanism of TACE: intra-arterial chemotherapy delivery and selective de-arterialization.
• To discuss the safety profile, potential side effects, and therapeutic goals of TACE.

Summary:

• TACE involves infusing chemotherapeutic agents into tumor-feeding vessels followed by embolization using particles during angiography.
• Various chemoembolization agents and techniques are reviewed, highlighting the procedure's safety and minimally invasive nature.
• Common side effects include postembolization syndrome; severe complications like hepatic insufficiency are rare.

Impact:

• TACE aims to control clinical symptoms, prolong progression-free survival, and maintain quality of life in HCC patients.
• It serves as a valuable bridging therapy before liver transplantation and as a neoadjuvant treatment.
• Individualized patient selection by an interdisciplinary tumor board is essential for optimizing TACE outcomes.