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Semin intervent Radiol 2018; 35(04): 350-355
DOI: 10.1055/s-0038-1673423
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Treatment of Liver Tumors with Transarterial Chemoembolization

Natalie Poliektov
1   Department of Radiology, University of Colorado College of Medicine, Aurora, Colorado
,
D. Thor Johnson
1   Department of Radiology, University of Colorado College of Medicine, Aurora, Colorado
› Author Affiliations
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Publication Date:
05 November 2018 (online)

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Liver cancer is the fifth most common cancer among men and the ninth most common cancer among women worldwide, and is the second most common cause of cancer mortality for men and women combined.[1] Moreover, liver cancer death rates currently have the most rapid rise of all cancer deaths among both sexes worldwide.[2] Chemotherapy treatment options have also been limited by general insensitivity to systemic chemotherapy.[3]

Transcatheter arterial embolization (TAE) was first reported in 1974 as a novel treatment for liver tumors.[4] In the early 1980s, utilization of lipiodol allowed inclusion of chemotherapy and the practice of transarterial chemoembolization (TACE) became widespread.[5] TACE combines conventional TAE with regional chemotherapy to selectively induce ischemia and chemotherapy effects within the tumor while minimizing damage to the untreated liver. It is currently indicated as the first-line treatment for patients with unresectable intermediate-stage hepatocellular carcinoma (HCC), for down staging patients to Milan's criteria for orthotopic liver transplant, as a bridging therapy to prevent transplant list drop off, and as a palliative treatment.[6] [7] [8]

While different methods of embolotherapy are commonly used in the treatment of liver tumors, management is variable across medical centers. This article aims to provide insight into the factors the authors consider in their clinical practice when determining appropriate treatment for a patient.