[Transarterial ablative therapy of hepatocellular carcinoma]. / Transarterielle ablative Therapien des hepatozellulären Karzinoms.

ABSTRACT

CLINICAL/METHODICAL ISSUE Due to late diagnosis and a lack of organs only about 30 % of patients suffering from hepatocellular carcinoma (HCC) undergo curative treatment. STANDARD RADIOLOGICAL METHODS: Transarterial chemoembolization (TACE) is a routine procedure in intermediate stage HCC. In addition transarterial embolization (TAE) and transarterial radioembolization (TARE) are available for these patients. PERFORMANCE For inoperable patients with HCC, TACE is superior to best supportive care in terms of survival. Combined with percutaneous ablation TACE achieves results similar to resection. ACHIEVEMENTS Current developments, such as drug-eluting beads, TARE and multimodal treatment are well suited to further improve outcome in patients with intermediate stage HCC. PRACTICAL RECOMMENDATIONS: Transarterial therapies in HCC should be applied in accordance with the Barcelona Clinic Liver Cancer (BCLC) criteria. Due to a better safety profile and potentially improved disease-free survival the use of drug-eluting beads should be liberally considered.