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World J Gastrointest Surg. Jun 27, 2022; 14(6): 528-537
Published online Jun 27, 2022. doi: 10.4240/wjgs.v14.i6.528
Transarterial chemoembolization failure/refractoriness: A scientific concept or pseudo-proposition
Shen Zhang, Bin-Yan Zhong, Lei Zhang, Wan-Sheng Wang, Cai-Fang Ni
Shen Zhang, Bin-Yan Zhong, Lei Zhang, Wan-Sheng Wang, Cai-Fang Ni, Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Author contributions: Zhang S and Zhong BY contributed equally to drafting the manuscript; Zhang L polished the vocabulary and the grammar; Wang WS and Ni CF shared responsibility for the study concept and design; all authors contributed to reviewing and criticizing revision of the manuscript and approving the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81901847; Natural Science Foundation of Jiangsu Province, No. BK20190177; and the Suzhou Science and Technology Youth Plan, No. KJXW2018003.
Conflict-of-interest statement: There are no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cai-Fang Ni, MD, PhD, Chief Doctor, Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. szncf@suda.edu.cn
Received: December 13, 2021
Peer-review started: December 13, 2021
First decision: January 27, 2022
Revised: February 8, 2022
Accepted: June 4, 2022
Article in press: June 4, 2022
Published online: June 27, 2022
Processing time: 196 Days and 2.1 Hours
Core Tip

Core Tip: The definitions in the current concept of transarterial chemoembolization (TACE) failure/refractoriness are not capable of guiding clinical practice. A persistent viable tumor lesion is a well-accepted item of TACE failure/refractoriness, but that is not the case when it comes to new lesions, portal vein tumor thrombosis or extrahepatic spread. Patients with recurrent hepatocellular carcinoma after TACE constitute a heterogenous group and the treatment modalities need to be individualized.