Combination percutaneous and intraarterial therapy for the treatment of hepatocellular carcinoma: a review.

Transcatheter arterial chemoembolization (TACE) and percutaneous ablation therapies have been shown to provide effective therapy and afford survival prolongation for patients with unresectable hepatocellular carcinoma (HCC). Both treatments, however, have inherent limitations that restrict their benefit; TACE is not a curative therapy and ablation efficacy is significantly limited by lesion size. Current treatment strategies aim to combine intraarterial and percutaneous liver-directed therapies synergistically to improve tumor response, and by extension improve patient survival. This article reviews the current literature on combination treatments, and examines the circumstances in which therapeutic combinations would improve tumor response and patient survival.