Review
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Sep 28, 2012; 4(9): 405-412
Published online Sep 28, 2012. doi: 10.4329/wjr.v4.i9.405
Embolization of liver tumors: Past, present and future
Ashwin Rammohan, Jeswanth Sathyanesan, Sukumar Ramaswami, Anand Lakshmanan, Perumal Senthil-Kumar, Ulagendra Perumal Srinivasan, Ravi Ramasamy, Palaniappan Ravichandran
Ashwin Rammohan, Jeswanth Sathyanesan, Anand Lakshmanan, Perumal Senthil-Kumar, Ulagendra Perumal Srinivasan, Ravi Ramasamy, Palaniappan Ravichandran, The Institute of Surgical Gastroenterology and Liver Transplantation, Centre for GI Bleed, Division of HPB Diseases, Stanley Medical College Hospital, Chennai 600001, India
Sukumar Ramaswami, Interventional Radiologist, Institute of Surgical Gastroenterology and Liver Transplantation, Centre for GI Bleed, Division of HPB Diseases, Stanley Medical College Hospital, Chennai 600001, India
Author contributions: Rammohan A, Sathyanesan J, Ramaswami S, Lakshmanan A, Senthil-Kumar P contributed to conception and design, acquisition, analysis and interpretation of data; Rammohan A, Sathyanesan J, Srinivasan UP, Ramasamy R drafted the article and revised it critically for important intellectual content; and Sathyanesan J and Ravichandran P gave the final approval of the version to be published.
Correspondence to: Dr. Ashwin Rammohan, The Institute of Surgical Gastroenterology and Liver Transplantation, Centre for GI Bleed, Division of HPB Diseases, Stanley Medical College Hospital, Old Jail Road, Chennai 600001, India. ashwinrammohan@gmail.com
Telephone: +91-98-84173583 Fax: +91-44-25289595
Received: June 18, 2012
Revised: August 26, 2012
Accepted: September 2, 2012
Published online: September 28, 2012
Abstract

Curative therapies for hepatocellular carcinoma (HCC), such as resection and liver transplantation, can only be applied in selected patients with early tumors. More advanced stages require local or systemic therapies. Resection of HCC offers the only hope for cure. Even in patients undergoing resection, recurrences are common. Chemoembolization, a technique combining intra-arterial chemotherapy with selective tumor ischemia, has been shown by randomized controlled trials to be efficacious in the palliative setting. There is now renewed interest in transarterial embolization/transarterial chemoembolization (TACE) with regards to its use as a palliative tool in a combined modality approach, as a neoadjuvant therapy, in bridging therapy before transplantation, for symptomatic indications, and even as an alternative to resection. There have also been rapid advances in the agents being embolized trans-arterially (genes, biological response modifiers, etc.). The current review provides an evidence-based overview of the past, present and future trends of TACE in patients with HCC.

Keywords: Liver tumors; Embolization; Chemoembolization; Review