TACE with or without systemic therapy?

Transarterial chemoembolisation (TACE) delivers a chemotherapeutic agent (usually doxorubicin) into the feeding vessels of a hepatocellular carcinoma (HCC) and blocks the subsequent perfusion of these vessels by the injection of a plugging material. Two randomized controlled trials, conducted 10years ago, reported a survival advantage for patients with a preserved liver function [1,2]. Subsequent meta-analysis confirmed that TACE increased the survival of patients with HCC [3,4]. TACE is a particularly attractive option for the management of patients with HCC because it is associated with few side effects and requires no more than a 24-h hospitalization.