Transarterial chemoembolization in Child-Pugh class B patients with hepatocellular carcinoma: Between the devil and the deep blue sea

摘要

To the Editor:We read with great interest the article by Hsu et al. (1, 2) and we also agree with the comments made by Peck-Radosavljevic in his editorial article. Indeed, following the conclusions of the study by Hsu et al. (1), ascitic patients with hepatocellular carcinoma (HCC) -and hence a fairly large proportion of Child-Pugh class B patients - should not undergo transarterial embolization (TACE) because of the inherent risk of precipitating renal failure, with a consequent detrimental effect on prognosis after treatment. Furthermore, as Child-Pugh class B patients are currently not candidates for palliative treatment with sorafenib (3), this assumption would mean that this particular category of patients would be beyond any effective treatment option (2).