• Hepatocellular carcinoma
• neovessels
• selective catheterization
• steep bifurcation
• steerable microcatheters
• transarterial chemoembolization

• CD8+T lymphocytes
• Hepatocellular carcinoma
• Programmed cell death ligand 1
• Transarterial embolization
• Tumour immune microenvironment

• Animals
• Rats
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/immunology
• Carcinoma, Hepatocellular/pathology
• Rats, Sprague-Dawley
• CD8-Positive T-Lymphocytes/immunology
• Embolization, Therapeutic/methods
• B7-H1 Antigen/metabolism
• Liver Neoplasms/therapy
• Liver Neoplasms/pathology
• Male
• Disease Models, Animal
• Liver Neoplasms, Experimental/therapy
• Liver Neoplasms, Experimental/immunology
• Liver Neoplasms, Experimental/pathology
• Flow Cytometry
• Ethiodized Oil

• SBK2023022210 Natural Science Foundation of Jiangsu Province
• BE2021648 Jiangsu Provincial Key Research and Development Program

Liver cancer is a malignant tumor with high morbidity and mortality. Transcatheter arterial chemoembolization (TACE) is the main method for surgically unresectable liver cancer. In recent years, drug-loaded microspheres have been gradually applied in TACE technology. There are some controversies about the therapeutic effects of drug-loaded microspheres TACE (D-TACE) and traditional TACE.

To explore the short-term efficacy of D-TACE and traditional TACE in the treatment of advanced liver cancer.

The clinical data of 73 patients with advanced liver cancer admitted to the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2017 to October 2019 were retrospectively analyzed. Among them, 15 patients were treated with D-TACE, and 58 patients were treated with traditional TACE. Clinical baseline characteristics, perioperative laboratory indices, postoperative adverse reactions and postoperative complications were compared between the two groups.

There was no statistical difference between the two groups for the postoperative response: The highest postoperative body temperature of the drug-loaded microsphere group was 38.0 ± 0.9℃ and the postoperative highest body temperature of the traditional TACE group was 38.3 ± 0.7℃ (t = -1.414, P = 0.162). For the 24 h postoperative nausea and vomiting after surgery in terms of scoring and postoperative pain scores, the traditional TACE group was higher than the drug-loaded microsphere group (χ² = 14.33, P = 0.014; χ² = 32.967, P = 0.000) and the two groups had significant statistical differences. The disease control rate at 3 mo after treatment in the drug-loaded microsphere group was 60% and the disease control rate at 3 mo after treatment in the traditional TACE group was 75.9% (χ² = 4.091, P = 0.252). There was no statistical difference between the two groups of data. During the follow-up period, the number of interventional treatments received was once in the drug-loaded microsphere group and the traditional TACE group received an average of 1.48 treatments (χ² = 10.444 P = 0.005). There was a statistical difference between the two groups.

Compared with traditional TACE, D-TACE may have some advantages in the treatment of advanced hepatocellular carcinoma with a large tumor load in the short term, but the long-term clinical efficacy needs additional follow-up studies. In addition, compared with the traditional group, the patients in the drug-loaded microsphere group had better subjective tolerance and could reduce the number of interventional treatments. Therefore, D-TACE is worthy of clinical promotion.

• Primary liver cancer
• Hepatocellular carcinoma
• Drug-loaded microsphere transcatheter arterial chemoembolization
• Traditional transcatheter arterial chemoembolization
• Treatment
• Short-term efficacy

• Transarterial chemoembolization
• efficacy
• huge hepatocellular carcinoma
• microwave ablation
• transarterial chemoembolization refractory

Multi-session transarterial chemoembolization (TACE) is usually needed for the treatment of intermediate-stage hepatocellular carcinoma (HCC), but it may not always have a positive influence on prognosis due to high heterogeneity of HCC. To avoid ineffective repeated TACE, the concept of TACE failure/refractoriness has been proposed by several organizations and is being addressed using tyrosine kinase inhibitors. The concept of TACE failure/refractoriness is controversial due to ambiguous definitions and low evidence-based data. To date, only a few studies have examined the rationality concerning the definition of TACE failure/refractoriness, although the concept has been introduced and applied in many TACE-related clinical trials. This review focuses on some of the issues related to different versions of TACE failure/refractoriness, the rationality of related definitions, and the feasibility of continuing TACE after so-called failure/refractoriness based on published evidence. A suggestion to re-define TAEC failure/refractoriness is also put forward.

• Hepatocellular carcinoma
• Transarterial chemoembolization
• Failure
• Refractoriness

• DEB-TACE
• HCC
• TACE
• chemoembolization
• liver
• review

• Balloon-occluded transcatheter arterial chemoembolization
• Hepatocellular carcinoma
• Transcatheter arterial chemoembolization

Careful selection of hepatocellular carcinoma (HCC) patients prior to chemoembolization treatment is a daily reality, and is even more necessary with new available therapeutic options in HCC.

To propose two new models to better stratify patients and maximize clinical benefit: “6 and 12” and “pre/post-TACE-predict” (TACE, transarterial chemoembolization).

We evaluated and compared their performance in predicting overall survival with other systems {Barcelona Clinic Liver Cancer (BCLC), Albumin-Bilirubin (ALBI) and NIACE [Number of tumor(s), Infiltrative HCC, alpha-fetoprotein, Child-Pugh (CP), and performance status]} in two HCC French cohorts of different stages enrolled between 2010 and 2018.

The cohorts included 324 patients classified as BCLC stages A/B (cohort 1) and 137 patients classified as BCLC stages B/C (cohort 2). The majority of the patients had cirrhosis with preserved liver function. “Pre-TACE-predict” and “6 and 12” models identified three distinct categories of patients exhibiting different prognosis in cohort 1. However, their prognostic value was no better than the BCLC system or NIACE score. Liver function based on CP and ALBI grades significantly impacted patient survival. Conversely, the “post-TACE-predict” model had a higher predictive value than other models. The stratification ability as well as predictive performance of these new models in an intermediate/advanced stage population was less efficient (cohort 2).

The newly proposed “Pre-TACE-predict” and “6 and 12” models offer an interesting stratification into three categories in a recommended TACE population, as they identify poor candidates, those with partial control and durable response. The models' contribution was reduced in a population with advanced stage HCCs.

• Hepatocellular carcinoma
• Transarterial chemoembolization
• Pre-TACE-predict
• Six-and-twelve
• Barcelona Clinic Liver Cancer
• Prognosis

• Diffusion-weighted imaging (DWI)
• Drug-eluting bead transarterial chemoembolization (DEB-TACE)
• Gd-EOB-DTPA-enhanced MRI
• Hepatocellular carcinoma (HCC)

• Balloon-occluded arterial stump pressure
• Balloon-occluded transcatheter arterial chemoembolization
• Hepatocellular carcinoma
• Micro-balloon catheter
• Prognosis
• Transcatheter arterial chemoembolization
• Treatment effect

• Asia-Pacific Primary Liver Cancer Expert
• Hepatocellular carcinoma
• Intermediate stage
• Systemic therapy
• Transarterial chemoembolization

• computed tomography
• contrast-enhanced ultrasonography
• hemangioma
• liver
• portal vein

• Angiography
• Contrast Media
• Diagnosis, Differential
• Female
• Hemangioma/blood supply
• Hemangioma/diagnostic imaging
• Hemangioma/pathology
• Hepatic Artery/diagnostic imaging
• Humans
• Liver Neoplasms/blood supply
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/pathology
• Magnetic Resonance Imaging
• Portal Vein/diagnostic imaging
• Tomography, X-Ray Computed
• Ultrasonography
• Young Adult

• conventional transarterial chemoembolization
• huge hepatocellular carcinoma
• prognosis

Ultraselective conventional transarterial chemoembolization (cTACE), defined as cTACE at the most distal portion of the subsubsegmental hepatic artery, is mainly performed for hepatocellular carcinoma (HCC) ≤5 cm. Distal advancement of a microcatheter enables injection of a larger volume of iodized oil into the portal vein in the limited area under non-physiological hemodynamics. As a result, the reversed portal flow into the tumor through the drainage route of the tumor that occurs when the hepatic artery is embolized is temporarily blocked. By adding gelatin sponge slurry embolization, both the hepatic artery and portal vein are embolized and not only complete necrosis of can be achieved. Ultraselective cTACE can cure small HCCs including less hypervascular tumor portions and replace surgical resection and radiofrequency ablation in selected patients.

• Chemoembolization, Therapeutic
• Conebeam computed tomography
• Gelatin sponge, Absorbable
• Hepatocellular carcinoma
• Iodized oil

• Chordate
• Evolution
• HCC
• Hormones and growth factors pancreatic family
• Liver
• Paradox
• Portal system
• Privileged metastasis
• Vertebrate

• Computed tomography
• Hepatocellular carcinoma
• Perfusion imaging
• Transarterial chemoembolization
• Treatment outcome

• Antineoplastic Agents/therapeutic use
• Carcinoma, Hepatocellular/classification
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/therapy
• Chemoembolization, Therapeutic/methods
• Follow-Up Studies
• Hepatectomy/methods
• Humans
• Japan
• Liver Neoplasms/classification
• Liver Neoplasms/pathology
• Liver Neoplasms/therapy
• Neoplasm Staging
• Reproducibility of Results
• Retrospective Studies
• Survival Rate

Here we report a case of a 76-year-old man with a giant cavernous hepatic hemangioma of more than 20 cm in diameter. Since the hepatic hemangioma was actually growing and might possibly rupture and he complained of abdominal symptoms, we decided to perform interventional therapy. First we performed transcatheter arterial embolization (TAE) of the hepatic arteries. However, since this was not sufficiently effective, we added sorafenib (600 mg/day). As a result, the tumor shrank with symptomatic improvement. Subsequently, an adverse event occurred, and we suspended the sorafenib therapy. Then, the tumor began to grow, and we resumed administering sorafenib at 400 mg/day. The tumor shrank again, and we continued the sorafenib therapy thereafter. The tumor shrinkage, although possibly induced by the effect of TAE, is considered primarily due to the effect of treatment with sorafenib, because (1) TAE did not sufficiently reduce the blood supply to the inside of the tumor; (2) other tumors shrank in the area not targeted by TAE; and (3) the tumor grew during suspension of sorafenib therapy and shrank again after resuming the treatment.

• Hepatic hemangioma
• Sorafenib
• Transcatheter arterial embolization