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TACE — Transarterial Chemoembolization

Locoregional liver tumor treatment via the hepatic artery

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is TACE — Transarterial Chemoembolization?

TACE is the standard of care for intermediate-stage hepatocellular carcinoma (BCLC stage B) and selected liver metastases.

Conventional TACE (cTACE) uses a chemotherapy-iodized oil emulsion (Lipiodol with doxorubicin or cisplatin), followed by gelfoam or other embolic material.

Drug-eluting bead TACE (DEB-TACE) loads chemotherapy onto microspheres that release drug locally with reduced systemic exposure.

Treatment is performed percutaneously via femoral or radial artery access in interventional radiology suites.

Provides survival benefit and tumor control as bridging therapy to liver transplantation, downstaging or palliative treatment.

Symptoms

Indication: intermediate-stage HCC, large or multifocal HCC not amenable to ablation or resection, palliation, or downstaging for transplantation
Preoperative criteria: preserved liver function (Child-Pugh A or selected B), patent portal vein, no extrahepatic spread, performance status acceptable
Post-embolization syndrome (low-grade fever, abdominal pain, nausea, transient transaminase rise) for 3–7 days is expected
Hospitalization typically 1–2 nights with overnight observation
Imaging follow-up (multiphasic CT or MRI) at 4–6 weeks; repeat TACE 'on demand' as residual or new disease appears

Risk Factors

Decompensated cirrhosis (Child-Pugh C, ascites, encephalopathy) generally precludes TACE
Main portal vein thrombosis is a relative or absolute contraindication
Severe biliary obstruction or extensive tumor burden raises liver failure risk
Renal insufficiency limits contrast administration
Cardiac or pulmonary disease may limit safe sedation or fluid management

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Multifocal or large HCC not suitable for surgery, transplantation or ablation
  • Need for downstaging in patients beyond transplant criteria
  • Bridge to liver transplantation with anticipated wait time over 6 months
  • Postoperative warning signs: high fever beyond 5 days, jaundice, severe pain, decreased urine output, encephalopathy
  • Late warning signs: ascites, marked weight loss, new abdominal mass — concern for progression

Treatment Methods

01
Multidisciplinary tumor board evaluation per BCLC algorithm
02
Pre-procedure imaging (triple-phase CT or MRI), Child-Pugh score, AFP, complete blood count, coagulation
03
Selective or superselective catheterization of tumor-feeding hepatic artery branches
04
Conventional TACE or DEB-TACE based on local protocol and patient profile
05
Post-procedure analgesia, antiemetics, hydration; monitoring of liver function
06
Treatment response assessment by mRECIST criteria on 4–6 week imaging
07
On-demand re-treatment for residual viable tumor; consideration of systemic therapy when TACE is no longer effective

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.