A tree symbolizes liver cancer treatment options, with flourishing branches representing TACE with RFA and slightly withering branches representing hepatectomy.

TACE vs. Surgery for Liver Cancer: Which Treatment is Best?

Avery Sinclair in Health & Wellness July 2025 • 4 min read.

"Exploring the latest research on liver cancer treatments, including TACE and surgical options, to help you make informed decisions."

Hepatocellular carcinoma (HCC), a type of liver cancer, is a significant global health challenge, ranking among the most common and deadly cancers worldwide. In countries like China, which accounts for over half of all HCC cases, the disease poses an especially heavy burden. When HCC is diagnosed beyond the Milan criteria—meaning the tumor is larger or there are multiple tumors—treatment becomes more complex. Doctors must consider factors like the patient's liver function and the extent of the cancer to determine the best course of action.

Two common treatments for HCC beyond the Milan criteria are transarterial chemoembolization (TACE) and surgery (hepatectomy). TACE is a minimally invasive procedure that delivers chemotherapy directly to the tumor through the hepatic artery. This helps to block the tumor's blood supply, slowing its growth. Hepatectomy, on the other hand, involves surgically removing the portion of the liver containing the tumor.

Deciding between TACE and surgery can be difficult. Both have potential benefits and risks, and the best choice depends on the individual patient's situation. Fortunately, recent research is shedding light on which approach may lead to better outcomes. This article explores a study comparing TACE combined with radiofrequency ablation (RFA) to hepatectomy, offering insights into how these treatments stack up.

TACE with RFA vs. Hepatectomy: Weighing the Options

A tree symbolizes liver cancer treatment options, with flourishing branches representing TACE with RFA and slightly withering branches representing hepatectomy.

A study published in "Cancer Management and Research" compared the effectiveness of TACE combined with radiofrequency ablation (RFA) versus hepatectomy in patients with HCC beyond the Milan criteria. The study retrospectively analyzed data from 270 patients treated at a single institution between January 2012 and December 2013.

In the study, 136 patients received TACE combined with RFA (TR group), while 134 underwent hepatectomy (HT group). The researchers then evaluated overall survival (OS), progression-free survival (PFS), and major complications in each group. Here’s a breakdown of what they found:

Overall Survival: The 1-, 2-, 3-, and 5-year OS rates were significantly higher in the TR group (98.5%, 83.1%, 66.2%, and 37.1%, respectively) compared to the HT group (89.6%, 69.4%, 53.7%, and 30.3%, respectively). The median survival time was 46 months for the TR group and 38 months for the HT group.
Progression-Free Survival: The median PFS was 21 months in the TR group and only 8 months in the HT group, indicating that TACE with RFA may delay cancer progression more effectively than surgery alone.
Independent Factors: Multivariate analysis identified treatment method, tumor diameter and number, Child-Pugh classification, antiviral therapy, and alpha-fetoprotein levels as independent factors affecting OS rates. Treatment mode, tumor diameter, and number were the independent factors affecting PFS.

The study concluded that TACE with RFA is superior to hepatectomy in treating hepatocellular carcinoma beyond the Milan criteria. This suggests that TACE with RFA may offer a less invasive and more effective option for patients who aren't ideal candidates for surgery or have more advanced disease.

Making Informed Decisions About Liver Cancer Treatment

Navigating a liver cancer diagnosis can feel overwhelming. Understanding the available treatment options and the latest research is crucial for making informed decisions in partnership with your healthcare team. While this study suggests that TACE with RFA may be a superior option for HCC beyond the Milan criteria, it's essential to discuss your individual circumstances with your doctor. They can assess your liver function, tumor characteristics, and overall health to determine the most appropriate and effective treatment plan for you.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/cmar.s182914, Alternate LINK

Title: Transarterial Chemoembolization With Radiofrequency Ablation Versus Hepatectomy In Hepatocellular Carcinoma Beyond The Milan Criteria: A Retrospective Study

Subject: Oncology

Journal: Cancer Management and Research

Publisher: Informa UK Limited

Authors: Hang Yuan, Ping Cao, Hai-Liang Li, Hong-Tao Hu, Chen-Yang Guo, Yan Zhao, Quan-Jun Yao, Xiang Geng

Published: 2018-11-01

Everything You Need To Know

What is the difference between TACE and hepatectomy in treating liver cancer?

TACE, or transarterial chemoembolization, is a minimally invasive procedure that delivers chemotherapy directly to the liver tumor via the hepatic artery. It aims to block the tumor's blood supply and slow its growth. Hepatectomy, on the other hand, is a surgical procedure where a portion of the liver containing the tumor is removed. The choice between these two treatments, especially for HCC beyond the Milan criteria, depends on various factors like the patient's liver function and the extent of the cancer.

How does the combination of TACE with radiofrequency ablation (RFA) compare to hepatectomy in terms of patient outcomes?

A study published in "Cancer Management and Research" compared TACE combined with RFA to hepatectomy. The study found that patients treated with TACE and RFA (TR group) had significantly higher 1-, 2-, 3-, and 5-year overall survival (OS) rates compared to those who underwent hepatectomy (HT group). The median survival time was also longer for the TR group. Additionally, the median progression-free survival (PFS) was notably longer in the TR group, indicating that TACE with RFA may delay cancer progression more effectively.

What are the Milan criteria, and why are they important when considering liver cancer treatments like TACE and hepatectomy?

The Milan criteria are guidelines used to determine the eligibility of patients with hepatocellular carcinoma (HCC) for liver transplantation. When HCC is diagnosed beyond the Milan criteria, meaning the tumor is larger or there are multiple tumors, treatment options become more complex. Treatments like TACE and hepatectomy are often considered for these patients. The study specifically focused on HCC cases beyond the Milan criteria, highlighting the challenges and the need for tailored treatment strategies.

Besides the treatment method, what other factors can influence the outcomes of liver cancer treatment?

The study identified several independent factors that affect both overall survival (OS) and progression-free survival (PFS). Besides the treatment method (TACE with RFA vs. hepatectomy), these include tumor diameter and number, the Child-Pugh classification (which assesses liver function), whether the patient is undergoing antiviral therapy, and alpha-fetoprotein levels. These factors underscore the importance of a comprehensive assessment of the patient's condition when determining the best course of action.

In light of the study's findings, what should patients and their doctors consider when choosing between TACE with RFA and hepatectomy?

The study suggests that TACE with RFA may be superior to hepatectomy for treating HCC beyond the Milan criteria, offering a less invasive and potentially more effective option. However, it is crucial to remember that the best treatment plan depends on the individual patient's circumstances. Doctors need to assess liver function, tumor characteristics, overall health, and the presence of any independent factors identified in the study. Patients should have an open discussion with their healthcare team to weigh the potential benefits and risks of each treatment option before making an informed decision.