P57 An audit of transarterial chemoembolisation (TACE) and transarterial embolisation (TAE) for hepatocellular carcinoma (HCC): pathology, procedures, complications and outcomes a single regional centre study over four years

<h3>Introduction</h3> Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Overall 1 year survival in England for liver cancer is approximately 40%, with an estimated 5 year survival of only 15% [BSG 2024, Cancer Research UK]. TACE and TAE are treatment options for intermediate BCLC stage disease, and as a downstaging approach for HCC to consider further curative strategies. This audit analysed data one year outcome data from a single NHS hospital for TACE and TAE between February 2021 and February 2025. <h3>Methods</h3> This audit assessed the pathology, procedures, complications and outcomes of TACE and TAE for a single regional HCC centre over 4 years. Two imaging systems (Philips and Siemens) were used over this period, with patients identified from radiology records. A combination of the patient information systems were then used to collect relevant data. This related to: Liver disease aetiology, co-morbidities, procedure dates, Child-Pugh, BCLC and HAP scores, radiation dose, procedure screening time, embolisation material, use of imaging tools, lesion size pre and post procedure, complications and outcomes at first imaging post procedure, six months, nine months and twelve months. <h3>Results</h3> In total there 77 patients who underwent 107 procedures (87 TACE and 20 TAE), average age 74 years. Looking at prognostic scoring, most had Child Pugh A, with HAP A scores. With regard to aetiology most patients had underlying MASLD (38%), followed by MetALD (32%). Anatomically, Segment VII and VIII had the highest representation for HCC. The most frequent comorbidities identified were metabolic (Hypertension, Diabetes and Dyslipidaemia). The most common embolisation material for TACE was Doxorubicin 75mg M1 beads and in TAE, 45–150 PVA particles. Post TACE/TAE procedure, 33% had non-viable disease at their first imaging (2 months). At 1 year: 18% had non-viable disease, 35% had stable or equivocal radiological disease. Progressive disease was seen in 20% of patients, Death was seen in 21% of patients at 1 year. Post-embolisation syndrome was seen in 7.8% (1 hospital admission), with 1 case of Pancreatitis (with hospital admission). <h3>Discussion</h3> This audit highlights that TACE or TAE for HCC can be effective in disease control in HCC. Survival was 79% at one year post TACE/TAE, treating an older patient group with comorbidities and principal metabolic and alcohol related drivers. Most patients had treatment response or stability at 1 year follow-up, with a low complication burden overall. <h3>References</h3> Suddle A, <i>et al</i>. British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults. <i>Gut</i> 2024;73(8). Cancer Research UK Liver Cancer Statistics 2025: accesssed June 2025 https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer#:~:text=Liver%20cancer%20five%2Dyear%20survival,99%20(2016%2D2020).