Hepatocellular carcinoma locoregional therapies: Outcomes and future horizons

Table 1 Locoregional therapy techniques, benefits, and risks

Locoregional modality	Techniques	Clinical advantages	Clinical risks
TACE	Drug-eluting beads or conventional delivery	Provides both local embolic and chemotherapeutic effect	PES, biloma, liver abscess, liver failure
TAE	Particulate or other embolic agents	Avoids radio and chemotoxicity; less expensive than other embolotherapies	PES, biloma, liver abscess, liver failure
TARE	Y90 microspheres	May be used in early disease with curative intent; intermediate disease can be used to increase FLV to qualify for curative intent surgery; best QoL scores of all options	PRS, RILD, radiation-induced pneumonitis, biloma, liver abscess, liver failure
Ablation	Radiofrequency current, microwaves, or cryoablation	Efficacious as monotherapy for early-stage disease; less morbidity than transarterial therapies	PAS, iatrogenic injury, bleeding

TACE: Transarterial chemoembolization; PES: Post-embolization syndrome; TAE: Transarterial embolization; TARE: Transarterial radioembolization; FLV: Functional liver volume; QoL: Quality of life; PRS: Post-radioembolization syndrome; RILD: Radiation-induced liver disease; PAS: Post-ablation syndrome.