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.