Chemoembolization, radioembolization, and other novel intra-arterial therapies

Hepatocellular carcinoma (HCC) is a malignancy that arises from aberrant hepatocytes and commonly occurs in the setting of underlying liver disease. The overwhelming majority of patients are precluded from surgical interventions; most patients are either unresectable/nontransplantable by current criteria or inoperable secondary to underlying comorbidities. For patients fortunate enough to undergo operative cure, exceptionally high five-year recurrence rates have been reported (1-4). Without treatment, the prognosis remains dismal and the outcome is uniformly fatal. Although survival depends on many factors, size and stage of tumor at presentation appear to be significant prognosticators of outcome.