TY - JOUR
T1 - Outcomes of Transarterial Embolisation (TAE) vs. Transarterial Chemoembolisation (TACE) for Hepatocellular Carcinoma
T2 - A Systematic Review and Meta-Analysis
AU - Lawson, Alexander
AU - Kamarajah, Sivesh K.
AU - Parente, Alessandro
AU - Pufal, Kamil
AU - Sundareyan, Ramanivas
AU - Pawlik, Timothy M.
AU - Ma, Yuk Ting
AU - Shah, Tahir
AU - Kharkhanis, Salil
AU - Dasari, Bobby V. M.
A2 - Sahin, Ilyas
PY - 2023/6/13
Y1 - 2023/6/13
N2 - 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.
AB - 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.
KW - transarterial chemoembolisation
KW - hepatocellular carcinoma
KW - transarterial embolisation
U2 - 10.3390/cancers15123166
DO - 10.3390/cancers15123166
M3 - Review article
C2 - 37370776
SN - 2072-6694
VL - 15
JO - Cancers
JF - Cancers
IS - 12
M1 - 3166
ER -