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JAMA Oncology Patient Page
November 2015

Transarterial Chemoembolization

JAMA Oncol. 2015;1(8):1178. doi:10.1001/jamaoncol.2015.3702

Transarterial chemoembolization (TACE) is a nonsurgical way to treat certain tumors in the liver.

When and How Is TACE Performed?

TACE may be performed on patients who have tumors that developed from the liver itself (hepatocellular carcinoma) or sometimes for patients with tumors of other parts of the body, such as from colon cancer, that have spread to the liver, if there are not too many sites of spread (metastases).

TACE delivers medications directly to the tumor in the liver using a catheter (a small flexible tube) that is inserted into an artery in the groin area. The TACE procedure is performed by a specialist, typically an interventional radiologist, who makes a very small incision in the groin to insert the catheter into the femoral artery. The catheter is then directed up through the aorta and to the hepatic artery, which provides the main blood supply to a tumor in the liver.

TACE can be used to deliver both chemotherapy and a substance that leads to blot clotting, or embolization. Embolization results in the blood supply to the tumor being blocked, which causes the cancer cells to die from lack of oxygen and nutrients. The substance used can be either tiny “microspheres,” metal coils, or a specialized gel.

Chemotherapy is delivered directly to the cancer at concentrations higher than can be achieved by giving it through a vein. The loss of blood flow from embolization keeps chemotherapy from being washed away from around the cancer, making it more effective.

Following TACE, treated tumors will often shrink significantly or even die, with no further living cancer cells remaining.

What Are the Potential Side Effects?

There is a small risk of bleeding and/or damage to blood vessels as well as infection. Intravenous contrast is also used to direct the catheter, which may have risks in people with kidney disease. This is associated with a small risk of an allergic reaction, kidney damage, or hypothyroidism (reduced function of the thyroid gland).

Because TACE commonly causes significant death to cancer cells immediately after the procedure, it can lead to a lot of inflammation in the area. Patients who undergo TACE commonly (about 60%-80% of the time) experience a postembolization syndrome of abdominal pain, fever, and low energy hours to days after the procedure. They can also have some liver function blood test results become abnormal. This syndrome typically resolves with time on its own, with pain medication, and sometimes intravenous fluids if needed. Antibiotics are not routinely needed.

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For More Information

To find this and other JAMA Oncology Patient Pages, go to the Patient Page link on the JAMA Oncology website at http://www.jamaoncology.com.

Section Editor: Howard (Jack) West, MD.
The JAMA Oncology Patient Page is a public service of JAMA Oncology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Oncology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

Published Online: October 15, 2015. doi:10.1001/jamaoncol.2015.3702.

Conflict of Interest Disclosures: None reported.

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