The Comité de l'évolution des pratiques en oncologie (CEPO) is a group of specialists in oncology reporting to the INESSS. Members of the CEPO are Karine Almanric BPharm/MSc/BCOP, Hôpital Cité-de-la-Santé (CSSS de Laval); Gino Boily PhD, INESSS; Philippe Bouchard BPharm/MSc/BCOP, Hôpital Maisonneuve-Rosemont; Jim Boulanger PhD, INESSS; Ghislain Cournoyer MD, Hôpital régional de Saint-Jérôme (CSSS de Saint-Jérôme); Félix Couture MD, Hôtel-Dieu de Québec (CHU de Québec); Normand Gervais MD, Centre hospitalier régional du Grand-Portage (CSSS de Rivière-du-Loup); Stéphanie Goulet PhD, INESSS; Marie-Pascale Guay BPharm/MSc/BCOP, Jewish General Hospital (MUHC); Rahima Jamal MD, Hôpital Notre-Dame (CHUM); Bernard Lespérance MD, Hôpital du Sacré-Cœur de Montréal, Groupe d'étude en oncologie du Québec; Nathalie Letarte BPharm/MSc/BCOP, Hôpital Notre-Dame (CHUM), Programme de gestion thérapeutique des médicaments; Jean-François Ouellet MD, Hôtel-Dieu de Québec (CHU de Québec); Gilles Pineau MD, INESSS; Raghu Rajan MD, Montreal General Hospital (MUHC); Isabelle Roy MD, Hôpital Cité-de-la-Santé (CSSS de Laval); Benoît Samson MD, Hôpital Charles-LeMoyne (CSSS Champlain-Charles-Le Moyne); and François Vincent MD, Centre hospitalier affilié universitaire régional (CSSS de Trois-Rivières)
Transarterial embolization therapies for the treatment of hepatocellular carcinoma: CEPO review and clinical recommendations
Version of Record online: 24 JUN 2014
© 2014 International Hepato-Pancreato-Biliary Association
Volume 17, Issue 1, pages 52–65, January 2015
How to Cite
Boily, G., Villeneuve, J.-P., Lacoursière, L., Chaudhury, P., Couture, F., Ouellet, J.-F., Lapointe, R., Goulet, S., Gervais, N. and Comité de l'évolution des pratiques en oncologie (2015), Transarterial embolization therapies for the treatment of hepatocellular carcinoma: CEPO review and clinical recommendations. HPB, 17: 52–65. doi: 10.1111/hpb.12273
Original work: This article is an adaptation of CEPO's original clinical practice guideline published in July 2013, freely available in its French version at http://www.msss.gouv.qc.ca/cancer. The Direction québécoise de cancérologie of the Ministère de la Santé et des Services sociaux du Québec provided financial support for the original guideline.
- Issue online: 8 DEC 2014
- Version of Record online: 24 JUN 2014
- Manuscript Accepted: 7 APR 2014
- Manuscript Received: 3 FEB 2014
Hepatocellular carcinoma (HCC) is one of the most deadly cancers in the world and its incidence rate has consistently increased over the past 15 years in Canada. Although transarterial embolization therapies are palliative options commonly used for the treatment of HCC, their efficacy is still controversial. The objective of this guideline is to review the efficacy and safety of transarterial embolization therapies for the treatment of HCC and to develop evidence-based recommendations.
A review of the scientific literature published up to October 2013 was performed. A total of 38 studies were included.
Considering the evidence available to date, the CEPO recommends the following: (i) transarterial chemoembolization therapy (TACE) be considered a standard of practice for the palliative treatment of HCC in eligible patients; (ii) drug-eluting beads (DEB)-TACE be considered an alternative and equivalent treatment to conventional TACE in terms of oncological efficacy (overall survival) and incidence of severe toxicities; (iii) the decision to treat with TACE or DEB-TACE be discussed in tumour boards; (iv) bland embolization (TAE) not be considered for the treatment of HCC; (v) radioembolization (TARE) not be considered outside of a clinical trial setting; and (vi) sorafenib combined with TACE not be considered outside of a clinical trial setting.