Tace To The Rescue: A Systematic Literature Review of Its Role in Battling Various Liver Metastases

Abstract

Liver metastasis, commonly originating from primary tumors such as colorectal, gastrointestinal, breast, and neuroendocrine malignancies, poses a significant treatment challenge. Patients with unresectable liver metastases are increasingly receiving transarterial chemotherapy (TACE) as a locoregional treatment. This systematic review evaluates the clinical outcomes, safety, and effectiveness of TACE in treating liver metastases across various cancer types. A systematic search of PubMed, PMC, and the Cochrane Library from January 2019 to December 2024 identified 848 articles. After removing 559 duplicates and excluding 167 abstracts, 122 full-text articles were assessed for eligibility. Exclusions included 30 case reports, 1 animal study, 3 non-English articles, 10 systematic reviews or meta-analyses, 2 pictorial reviews, 32 articles without available full text, 13 with no reported outcomes, and 2 retracted articles. The final analysis included 29 trials with 3,652 participants. Eight studies provided comparative data, while the rest were retrospective. The data suggest that TACE offers promising tumor control and may improve survival, but its effectiveness is influenced by factors like tumor burden, vascularization, and the underlying malignancy. Differences in treatment protocols, including chemotherapeutic agents and embolization materials, also affect outcomes. While TACE is generally well-tolerated, adverse effects such as liver function impairment and post-embolization syndrome have been observed. The review emphasizes the need for more randomized controlled trials and standardized treatment guidelines to better define TACE’s role in managing liver metastases.