Fite Elliott L, Makary Mina S
College of Medicine, The Ohio State University, Columbus, OH 43210, USA.
Department of Radiology, The Ohio State University Medical Center, Columbus, OH 43210, USA.
Cancers (Basel). 2024 Jul 1;16(13):2430. doi: 10.3390/cancers16132430.
Hepatocellular carcinoma (HCC) accounts for 90% of liver cancer cases worldwide and is currently the most quickly increasing cause of cancer-related deaths in the United States. The 5-year survival rate for primary liver cancer is estimated to be below 20%, and HCC mortality is expected to increase by 41% by 2040. Currently, surgical resection is the first-line approach to definitive treatment of early-stage HCC. However, the majority of patients present with late-stage, unresectable disease due to the asymptomatic nature of early HCC. For patients who present with unresectable HCC, locoregional therapies such as transarterial chemoembolization (TACE) represent an alternative approach to HCC treatment. TACE is a minimally invasive, catheter-based technique that allows for targeted delivery of chemotherapy to tumor sites while occluding tumor-feeding blood vessels. In appropriately selected patients, outcomes for TACE therapy have been shown to be more favorable than supportive care or conservative management. The increasing incidence and mortality of HCC, in addition to the late-stage presentation of most HCC patients, demonstrates the need to expand the role of locoregional therapies in the treatment of HCC. TACE represents an appealing approach to HCC management, including disease control, palliation, and potentially curative-intent strategies. In this review, we will describe the current utility of TACE in the treatment of HCC, characterize the outcomes of patients treated with TACE across different HCC stages, and outline future applications of TACE in the treatment paradigm.
肝细胞癌（HCC）占全球肝癌病例的90%，目前是美国癌症相关死亡中增长最快的原因。原发性肝癌的5年生存率估计低于20%，预计到2040年HCC死亡率将增加41%。目前，手术切除是早期HCC确定性治疗的一线方法。然而，由于早期HCC无症状的特点，大多数患者就诊时已处于晚期、不可切除阶段。对于不可切除的HCC患者，经动脉化疗栓塞术（TACE）等局部区域治疗是HCC治疗的另一种方法。TACE是一种微创的、基于导管的技术，可在阻断肿瘤供血血管的同时将化疗药物靶向递送至肿瘤部位。在适当选择的患者中，TACE治疗的结果已被证明比支持治疗或保守治疗更有利。HCC发病率和死亡率的上升，以及大多数HCC患者就诊时已处于晚期，表明需要扩大局部区域治疗在HCC治疗中的作用。TACE是一种有吸引力的HCC治疗方法，包括疾病控制、姑息治疗和潜在的根治性策略。在本综述中，我们将描述TACE在HCC治疗中的当前应用，阐述不同HCC阶段接受TACE治疗患者的结果，并概述TACE在治疗模式中的未来应用。
