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World J Gastroenterol. Mar 28, 2014; 20(12): 3069-3077
Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3069
Transarterial chemoembolization and bland embolization for hepatocellular carcinoma
Emmanuel A Tsochatzis, Evangelia Fatourou, James O’Beirne, Tim Meyer, Andrew K Burroughs
Emmanuel A Tsochatzis, Evangelia Fatourou, James O’Beirne, Andrew K Burroughs, Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, London NW3 2QG, United Kingdom
Tim Meyer, Department of Oncology, Royal Free Hospital and UCL, London NW3 2QG, United Kingdom
Author contributions: Tsochatzis EA prepared the first draft of this manuscript; all authors reviewed the manuscript for important intellectual content and approved the final version.
Correspondence to: Emmanuel A Tsochatzis, MD, MSc, FEBTM, PhD, Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, Pond Street, London NW3 2QG, United Kingdom. e.tsochatzis@ucl.ac.uk
Telephone: +44-20-7794500 Fax +44-20-74726226
Received: October 7, 2013
Revised: December 23, 2013
Accepted: January 8, 2014
Published online: March 28, 2014
Processing time: 170 Days and 13.3 Hours
Abstract

Transarterial chemoembolization (TACE) is the first line treatment for patients with intermediate stage hepatocellular carcinoma but is also increasingly being used for patients on the transplant waiting list to prevent further tumor growth. Despite its widespread use, TACE remains an unstandardized procedure, with variation in type and size of embolizing particles, type and dose of chemotherapy and interval between therapies. Existing evidence from randomized controlled trials suggest that bland transarterial embolization (TAE) has the same efficacy with TACE. In the current article, we review the use of TACE and TAE for hepatocellular carcinoma and we focus on the evidence for their use.

Keywords: Cirrhosis; Hepatocellular carcinoma; Mortality; Embolization; Transarterial chemoembolization; Transarterial embolization; Prognosis

Core tip: In the current article, we review the use of transarterial chemoembolization (TACE) and transarterial embolization (TAE) for hepatocellular carcinoma and we focus on the evidence for their use. Apart from their use in intermediate stage hepatocellular carcinoma, we also review the evidence for their use as neo-adjuvant treatment in the pre-transplant setting. We also highlight the fact that there is no conclusive evidence for superiority of TACE over TAE.