Abstract
Introduction: Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Despite surgery represents the best treatment option, a significant part of malignancies are diagnosed at advanced tumor stage or with a poor liver function. Transhepatic Arterial Chemembolization (TACE) and Transhepatic Arterial Radioembolization (TARE) represent two therapeutic option for unresectable HCC. Aim of this systematic review is to compare the effectiveness of these treatments in patients with unresectable HCC. Methods: Medical databases were searched for potentially relevant publications. Overall survival rate, time to progression, 1-year survival rate, tumor response and complications rate were compared and analysed. Results: Eight studies were included in our systematic review for a total of 1030 and 401 patients treated with TACE and TARE respectively. The data showed a not statistically significant difference in survival and a statistically significant lower incidence in adverse events for TARE. The response analysis was affected by a significant response evaluation methods heterogeneity which substantially reduced our analysis power. Conclusion: Both procedures were useful as treatment options for unresectable HCC, showing a greater tolerability for TARE. However we believe that further studies, with a prospective design and a more comprehensive patients classification, could show more differences in selected patients.
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