Transarterial chemoembolisation is not superior to embolisation alone: The recent European Association for the Study of the Liver (EASL)–European Organisation for Research and Treatment of Cancer (EORTC) guidelines

The recent European Association for the Study of the Liver (EASL)–European Organisation for Research and Treatment of Cancer (EORTC) guidelines on hepatocellular carcinoma (HCC) state that transarterial chemoembolisation (TACE) is superior to transarterial embolisation (TAE) and should be considered as the therapy of choice. Interestingly and unlike other recommendations, this was not given any grade of evidence. However evidence exists which suggests that TACE and TAE have similar therapeutic efficacy, whilst the latter has lower costs and avoids the side-effects of chemotherapy as we have highlighted previously. The lack of standardisation of embolisation therapies, which includes the use of different embolising and chemotherapeutic agents and the timing and interval between treatment sessions have led to varying results. This may be one reason why the recent Cochrane meta-analysis showed no therapeutic benefit of TACE/TAE compared to the controls, as no consideration was given to the heterogeneity of techniques. Here we summarise the exist-