Journal
WORLD JOURNAL OF GASTROINTESTINAL SURGERY
Volume 14, Issue 6, Pages 528-537Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.4240/wjgs.v14.i6.528
Keywords
Hepatocellular carcinoma; Transarterial chemoembolization; Failure; Refractoriness
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Funding
- National Natural Science Foundation of China [81901847]
- Natural Science Foundation of Jiangsu Province [BK20190177]
- Suzhou Science and Technology Youth Plan [KJXW2018003]
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This article discusses the concept of TACE failure/refractoriness, pointing out its ambiguous definition and lack of evidence-based data. The author proposes a suggestion for redefining TACE failure/refractoriness.
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.
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