ArticleFrontiers in oncology2022
Transarterial Chemoembolization for Hepatocellular Carcinoma in Clinical Practice: Temporal Trends and Survival Outcomes of an Iterative Treatment.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 19 citations in OpenAlex.
- Changing Treatment Landscape of Hepatocellular Carcinoma: A Real-World Retrospective Analysis of Treatment Algorithms and Outcomes of Patients over 10 Years.Targeted oncology · 2026Article
- Artificial intelligence-driven CT radiomics model predicts prognosis in TACE-refractory hepatocellular carcinoma.Abdominal radiology (New York) · 2026Article
- Comparative Efficacy of Initial Treatment Strategies in Patients with Transarterial Chemoembolisation-Unsuitable Hepatocellular Carcinoma.Liver cancer · 2026Article
- Cost-Benefit Analysis of Trans-Arterial Radio-Embolization with Y-90 Glass Microspheres Versus Drug-Eluting Bead Trans-Arterial Chemo-Embolization in Patients with Hepatocellular Carcinoma in Italy.Cardiovascular and interventional radiology · 2025Article
- Advantages and Possibility of Transcription Factors FOXOs in HCC.Cell biochemistry and function · 2025Review
- Outcome of hepatic resection for HCC in ideal and non-ideal candidates.Hepatology communications · 2025Article
- Correspondence to editorial on "Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea".Journal of liver cancer · 2025Article
- Post-TACE ALBI-Score Trajectory in Intermediate and Advanced Hepatocellular Carcinoma: Prognostic Implications and Influencing Factors Analysis.Journal of hepatocellular carcinoma · 2025Article
- Effects of Short-Term Lenvatinib Administration Prior to Transarterial Chemoembolization for Hepatocellular Carcinoma.Cancers · 2024Article
- Postoperative subphenotypes modified the hepatoma arterial-embolization prognostic score: A novel smHAP-II nomogram.Journal of Cancer · 2024Article
- Angiogenesis and Hepatocellular Carcinoma: From Molecular Mechanisms to Systemic Therapies.Medicina (Kaunas, Lithuania) · 2023Review
- An Integrated Liver Function, Systemic Inflammation, and Tumor Characteristic Score Predicts Prognosis in Hepatocellular Carcinoma After Curative Resection.Annals of surgical oncology · 2023Article
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27 authors at 18 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTransarterial chemoembolization (TACE) is one of the most frequently applied treatments for hepatocellular carcinoma (HCC) worldwide. In this study, we aimed at evaluating whether and how TACE application and repetition, as well as the related outcome, have changed over the last three decades in Italy.
methodsData of 7,184 patients with HCC were retrieved from the Italian Liver Cancer (ITA.LI.CA) database. Patients were divided according to the period of diagnosis in six cohorts: P1 (1988-1993), P2 (1994-1998), P3 (1999-2004), P4 (2005-2009), P5 (2010-2014), and P6 (2015-2019). All the analyses were repeated in the overall patient population and in Barcelona Clinic Liver Cancer (BCLC) B patients, who are the subgroup of HCC patients originally supposed to receive TACE according to guidelines. TACE was defined as either the first or the main (more effective) treatment.
resultsThe proportion of patients receiving TACE as first or main therapy declined over time, and less than 50% of BCLC B patients were treated with chemoembolization from P3 onward. Conversely, TACE was widely used even outside the intermediate stage. Survival of TACE-treated patients progressively increased from P1 to P6. Although TACE was performed only once in the majority of patients, there was an increasing proportion of those receiving 2 or ≥3 treatments sessions over time. The overall survival (OS) of patients undergoing repeated treatments was significantly higher compared to those managed with a single TACE (median OS 40.0 vs. 65.0 vs. 71.8 months in 1, 2, and ≥3 TACE groups, respectively; p < 0.0001). However, after a first-line TACE, the adoption of curative therapies provided longer survival than repeating TACE (83.0 vs. 42.0 months; p < 0.0001), which in turn was associated with better outcomes compared to systemic therapies or best supportive care (BSC).
conclusionsDespite a decline in the percentage of treated patients over time, TACE has still an important role in the management of HCC patients. The survival of TACE-treated patients gradually improved over time, probably due to a better patient selection. Iterative TACE is effective, but an upward shift to curative therapies provides better outcomes while transition to systemic therapies and BSC leads to a worse prognosis.
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