Liver Cancer Due to Cirrhosis
Advanced TACE treatment for hepatocellular carcinoma (HCC)
Understanding Liver Cancer and Cirrhosis
Liver cancer often develops in the context of liver cirrhosis, which is the scarring of the liver tissue due to chronic liver damage. Common causes of cirrhosis include chronic hepatitis B or C infections, long-term alcohol abuse, and non-alcoholic fatty liver disease (NAFLD).
Cirrhosis significantly increases the risk of developing hepatocellular carcinoma (HCC), the most common type of primary liver cancer.
What is Transarterial Chemoembolization (TACE)?
Transarterial chemoembolization (TACE) is a minimally invasive procedure used to treat liver cancer, particularly hepatocellular carcinoma (HCC) in patients with cirrhosis.
TACE is not a curative treatment but is used to control tumor growth, reduce symptoms, and prolong survival. It is typically considered when the tumor is not suitable for surgical removal or liver transplantation.
Procedure Details
Pre-Procedure
A thorough assessment including imaging studies like CT scan, MRI, and liver function tests is performed to evaluate the extent of cancer and liver function. A multidisciplinary team, including an interventional radiologist, oncologist, and hepatologist, usually determines the appropriateness of TACE for the patient.
During the Procedure
The procedure is done under local anesthesia with sedation. A catheter is inserted into the femoral artery (in the groin) and guided to the hepatic artery, which supplies blood to the liver.
Once the catheter is in position, chemotherapy drugs are delivered directly into the blood vessels feeding the tumor. To enhance the effect of the chemotherapy, embolic agents (tiny particles) are also injected to block the blood flow, trapping the chemotherapy in the tumor and cutting off its blood supply. The procedure typically lasts 1-2 hours.
Post-Procedure
Patients may stay in the hospital for observation for a day or two. Common side effects include fever, pain in the abdomen, and nausea, collectively referred to as post-embolization syndrome.
Recovery usually takes a week or two, with most patients returning to normal activities shortly after.
Benefits of TACE
Localized Treatment
Directly targets the liver tumor, minimizing systemic side effects compared to traditional chemotherapy.
Tumor Control
Helps shrink the tumor or slow its growth, potentially making surgical resection or transplantation possible.
Prolongs Survival
Can extend survival time in patients with intermediate-stage HCC who are not candidates for curative treatments.
Minimally Invasive
No large surgical incisions required, leading to faster recovery than traditional surgery.
Risks and Considerations
- •Liver Function Impact: Since TACE restricts blood flow to parts of the liver, it can further impair liver function, especially in cirrhotic patients.
- •Post-Embolization Syndrome: A common side effect, including fever, pain, and malaise, managed with medication.
- •Tumor Recurrence: Although TACE can control tumor growth, HCC often recurs, requiring repeated treatments.
- •Complications: Possible risks include liver failure, infection, and non-target embolization.
Who is a Candidate for TACE?
- ✓Patients with intermediate-stage HCC (BCLC stage B) with no vascular invasion or extrahepatic spread
- ✓Patients with good liver function (Child-Pugh A or B) who are not suitable for surgical resection or liver transplantation
- ✓Patients with multiple liver tumors confined to the liver without major portal vein involvement
Follow-Up Care
Regular imaging studies (CT, MRI) are needed to monitor the effectiveness of the treatment and to detect any tumor recurrence. Ongoing management of liver cirrhosis and its complications is essential.
Potential need for additional treatments, including repeat TACE, systemic therapy, or other interventional procedures, based on tumor response and liver function.
Expert Liver Cancer Care
Our multidisciplinary team specializes in advanced treatments for HCC in cirrhotic patients.
Key Facts About TACE
Procedure Duration
1-2 hours
Hospital Stay
1-2 days typically
Recovery Time
1-2 weeks
Effectiveness
60-80% tumor response rate
Repeat Treatments
Often needed every 2-3 months