Benefits of Transarterial Chemoembolization (TACE) in Liver Cancer

This type of tumor is included in the top 10 most cancers in Indonesia. Mostly, people with HCC have a history of chronic liver disease with risk factors such as hepatitis B and C virus infections, liver disease due to alcohol consumption and non-alcoholic steatohepatitis. Other risk factors can also contribute to the incidence of HCC such as diabetes mellitus, obesity, metabolic or hereditary diseases as well as aflatoxin contaminated foods such as grains, corn, cassava, peanuts, and fermented soybeans.

The diagnosis of HCC can be made through anamesis of the risk factors for HCC as described above. Examination of serum alpha-fetoprotein (AFP) markers by ultrasound examination (USG), CT Scan and MRI can help confirm the diagnosis. BCLC is a HCC classification that is used to determine therapy at each stage. There are 5 categories of BCLC namely 0, A, B, C, and D, where BCLC 0 is a very early stage, while BCLC D is a terminal stage.

In stages BCLC 0 and A, curative therapies such as resection surgery, liver transplantation, and ablation can be considered. As for stage BCLC B, palliative therapy with TACE is recommended. At stage BCLC C can be given chemotherapy and supportive therapy can still be given in terminal patients (BCLC D).TACE (Transarterial Chemoembolisation) is a therapy that combines chemotherapy and embolization. This procedure is done by injecting drugs into the cancer area and blocking the flow of blood to the cancer cells in the liver. TACE can be done to shrink the size of the tumor, until it is small enough to be removed surgically. This procedure cannot be performed on people with cirrhosis, impaired liver and kidney function, disorders of blood clotting, or there is a blockage in the bile duct.

The process starts by inserting a catheter through the groin veins, then the tumor blood vessels are searched for and then the TACE procedure will begin by blocking the arterial pathway that provides food so that cells cannot get food from the blood vessels. TACE has the advantage of being more targeted, because it is directly targeted at tumor cells and the side effects caused are also minimal so as not to interfere with the activities of patients who are undergoing this therapy. TACE is the locoregional therapy of choice in managing intermediate to advanced stages of HCC. At present, many studies have examined the use of TACE therapy in the early stages and even the most recent stage at which TACE gives better results in HCC patients.