Outcomes of Transarterial Embolisation (TAE) vs. Transarterial Chemoembolisation (TACE) for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
by
, ,
Alexander Lawson
1,
Sivesh K. Kamarajah
2,
Alessandro Parente
2,
Kamil Pufal
1,
Ramanivas Sundareyan
3,
Timothy M. Pawlik
4
,
Yuk Ting Ma
5,
Tahir Shah
6,
Salil Kharkhanis
3 and
Bobby V. M. Dasari
2,7,* 1
Birmingham Medical School, University of Birmingham, Birmingham B15 2TT, UK
2
Department of HPB and Liver Transplantation, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
3
Department of Radiology, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
4
Department of Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH 43210, USA
5
Department of Oncology, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
6
Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
7
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(12), 3166; https://doi.org/10.3390/cancers15123166
Submission received: 6 April 2023
/
Revised: 26 April 2023
/
Accepted: 27 April 2023
/
Published: 13 June 2023
(This article belongs to the Special Issue Recent Advances in Hepatobiliary Cancers: From Diagnosis to Treatment)
Simple Summary
Non-surgical management of hepatocellular carcinoma (HCC) is used for selected patients. Of these management options, transarterial embolisation (TAE) and transarterial chemoembolisation (TACE) are the two main locoregional treatment options. There was no difference in OS among patients treated with TACE/TAE, single versus repeat treatments. Post-procedural adverse effects were higher in the TACE group but were not statistically significant. TACE has a comparable long-term survival and complications profile to TAE for patients with HCC. However, the low-to-moderate quality of current RCTs warrants high-quality RCTs, which are necessary to provide enough evidence to give a definitive answer and inform treatment plans for the future.
Abstract
Although hepatocellular carcinoma is increasingly common, debate exists surrounding the management of patients with unresectable disease comparing transarterial embolisation (TAE) or transarterial chemoembolisation (TACE). This study aimed to compare the outcomes of patients receiving TAE and TACE. A systematic review was performed using PubMed, Medline, Embase, and Cochrane databases to identify randomised controlled trials (RCTs) until August 2021. The primary outcome was overall survival (OS) and the secondary outcomes were progression-free survival (PFS) and adverse events. Five studies with 609 patients were included in the analysis. There was no statistically significant difference in the OS (p = 0.36) and PFS (p = 0.81). There was no difference in OS among patients treated with a single TACE/TAE versus repeat treatments. Post-procedural adverse effects were higher in the TACE group but were not statistically significant. TACE has comparable long-term survival and complications profile to TAE for patients with HCC. However, the low-to-moderate quality of current RCTs warrants high-quality RCTs are necessary to provide enough evidence to give a definitive answer and inform treatment plans for the future.
