Transarterial chemoembolization in patients with hepatocellular carcinoma

Curative therapies for hepatocellular carcinoma, such as liver transplantation, liver resection and percutaneous ablation can be applied to in a small number of patients (30-40%) with hepatocellular carcinoma. In patients with advanced stages different palliative therapies had been tested. Arterial embolization with or without chemotherapy had been one of the most used therapies. The ideal candidates for this option are patients with well-preserved liver function with multinodular asymptomatic tumours without vascular invasion. In these cases, objective response rates of 30-50% can be achieved, with an increase in patient's survival. The procedure is quite sure and the treatment-related mortality is less than 4%, and the most frequent complication is the so-called postembolization syndrome. With the intention to reduce tumoral progression during the stay in the waiting list for liver transplantation, most centres uses chemoembolization as a bridge to liver transplantation. However, there is insufficient evidence that chemoembolization offers any benefit when used prior to liver transplant, neither for early nor for advanced HCC. Copyright © 2008 Aran Ediciones, s. l.