Peer-review started: July 20, 2014
First decision: October 14, 2014
Revised: October 28, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: January 27, 2015
Hepatocellular carcinoma (HCC) is one of the few cancers whose incidence has been continually increasing over recent years. Resection of HCC offers the only hope for cure. However, recurrences are common in patients who have undergone resection. In our opinion, the effectiveness with which transarterial chemoembolization (TACE) as a neoadjuvant therapy for resectable HCC prevents recurrence and prolongs survival has not been conclusively demonstrated. All published meta-analyses have consistently failed to demonstrate that preoperative TACE improves the prognosis of resectable HCC. We believe that these published articles have several limitations and have our own views about the results of meta-analyses. It is very important that the scientific community shed more light on the pathogenesis of HCC and relate this to choice of therapy. This review mainly concerns our understanding of preoperative TACE for resectable HCC and briefly addresses desirable directions for future studies.
Core tip: Hepatocellular carcinoma (HCC) is the sixth most common neoplasm and third most frequent cause of cancer deaths. Resection of HCC offers the only hope for a cure, yet post-resection recurrence is common. The effectiveness of transarterial chemoembolization (TACE) as a neoadjuvant therapy for resectable HCC has not been conclusively demonstrated. All published meta-analyses have consistently failed to demonstrate its effectiveness. We believe these articles have several limitations and TACE is theoretically helpful in multinodular or infiltrative types of HCC.