AIMS: Advanced hepatocellular carcinoma (HCC) with vascular invasion or extrahepatic metastasis has been considered a contraindication for transarterial chemoembolization (TACE) treatment according to Barcelona Clinic Liver Cancer (BCLC) staging classification. However, real clinical practice varies among different countries. In recent years another opinion has been developing that considers that TACE can be safely performed in advanced HCC patients. METHODS: All studies on the efficacy of TACE for patients with advanced HCC were identified via the PubMed database. The primary items were TACE and HCC. RESULTS: We identified 15 studies in the treatment of TACE in advanced HCC patients. Most adverse events reported were treated successfully and in these studies there were no procedure-related deaths within 4 weeks of the TACE treatment. Four controlled studies reported that TACE increased survival rate and prolonged overall survival compared with conservative management. The most frequent prognostic factors were liver function and the degree of portal vein tumor thrombosis. CONCLUSION: TACE can be safely performed in advanced HCC patients with vascular invasion or extrahepatic spread and may improve their overall survival. Patients with portal vein branch invasion and well-preserved liver function seemed to derive optimal benefit from treatment with TACE. Further studies are needed to provide strong evidence of the efficacy of TACE for advanced HCC patients to update the BCLC staging system.
AIMS: Advanced hepatocellular carcinoma (HCC) with vascular invasion or extrahepatic metastasis has been considered a contraindication for transarterial chemoembolization (TACE) treatment according to Barcelona Clinic Liver Cancer (BCLC) staging classification. However, real clinical practice varies among different countries. In recent years another opinion has been developing that considers that TACE can be safely performed in advanced HCCpatients. METHODS: All studies on the efficacy of TACE for patients with advanced HCC were identified via the PubMed database. The primary items were TACE and HCC. RESULTS: We identified 15 studies in the treatment of TACE in advanced HCCpatients. Most adverse events reported were treated successfully and in these studies there were no procedure-related deaths within 4 weeks of the TACE treatment. Four controlled studies reported that TACE increased survival rate and prolonged overall survival compared with conservative management. The most frequent prognostic factors were liver function and the degree of portal vein tumor thrombosis. CONCLUSION:TACE can be safely performed in advanced HCCpatients with vascular invasion or extrahepatic spread and may improve their overall survival. Patients with portal vein branch invasion and well-preserved liver function seemed to derive optimal benefit from treatment with TACE. Further studies are needed to provide strong evidence of the efficacy of TACE for advanced HCCpatients to update the BCLC staging system.
Authors: Dominik Bettinger; David J Pinato; Michael Schultheiss; Rohini Sharma; Lorenza Rimassa; Tiziana Pressiani; Michela E Burlone; Mario Pirisi; Masatoshi Kudo; Joong Won Park; Nico Buettner; Christoph Neumann-Haefelin; Tobias Boettler; Nasrin Abbasi-Senger; Horst Alheit; Wolfgang Baus; Oliver Blanck; Sabine Gerum; Mathias Guckenberger; Daniel Habermehl; Christian Ostheimer; Oliver Riesterer; Jörg Tamihardja; Anca-Ligia Grosu; Robert Thimme; Thomas Baptist Brunner; Eleni Gkika Journal: Liver Cancer Date: 2018-07-12 Impact factor: 11.740
Authors: David J Pinato; Tadaaki Arizumi; Jeong Won Jang; Elias Allara; Puvan I Suppiah; Carlo Smirne; Paul Tait; Madhava Pai; Glenda Grossi; Young Woon Kim; Mario Pirisi; Masatoshi Kudo; Rohini Sharma Journal: Oncotarget Date: 2016-07-12