Transarterial Chemoembolization in Hepatocellular Carcinoma: Lessons from a 10-Year Real-World Retrospective Study

Area of Science:

• Hepatology
• Interventional Radiology
• Oncology

Background:

• Transarterial chemoembolization (TACE) is a primary treatment for intermediate-stage hepatocellular carcinoma (HCC).
• Emerging evidence suggests TACE may benefit selected early-stage HCC patients unsuitable for resection or ablation.
• This study evaluates long-term outcomes of TACE in a large single-center cohort.

Purpose of the Study:

• To assess the long-term efficacy of TACE for HCC.
• To compare outcomes across different Barcelona Clinic Liver Cancer (BCLC) stages.
• To identify factors influencing TACE treatment success.

Main Methods:

• Retrospective observational cohort study of 195 HCC patients treated with TACE (2013-2023).
• Data collected and analyzed according to STROBE guidelines.
• Overall survival (OS) and progression-free survival (PFS) estimated using Kaplan-Meier analysis.

Main Results:

• Median follow-up was 56 months; 55.4% BCLC stage A, 43.6% BCLC stage B.
• Median OS for the cohort was 56 months.
• PFS was significantly longer in stage A vs. stage B (15 vs. 9 months, p=0.003). Early treatment modification correlated with worse outcomes, while subsequent curative therapies improved survival.

Conclusions:

• TACE provides sustained tumor control and prolonged survival in HCC patients, outperforming previous reports.
• TACE is particularly effective for early-stage HCC patients ineligible for standard curative treatments.
• Centralization, multidisciplinary evaluation, tailored therapy, and regular reassessment are crucial for optimizing TACE outcomes.