What Is Superselective Tace?

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Key Takeaways

  • Superselective TACE is a specialized type of TACE treatment for liver cancer
  • It delivers chemo right to the tumor’s blood supply using a tiny tube
  • ss-TACE may work better than regular TACE for some patients
  • It is used for specific types and stages of liver cancer when surgery is not an option
  • ss-TACE can improve survival compared to non-selective TACE
  • Guidelines recommend TACE should be superselective when possible


Liver cancer is a serious health problem around the world. When liver cancer cannot be removed with surgery, one treatment option is something called transarterial chemoembolization (TACE). TACE delivers chemotherapy directly to liver tumors. It also blocks off the blood vessels around the tumors to cut off their blood supply and food.

There are a few different ways to do TACE. One advanced type is called superselective TACE, or ss-TACE. This article will explain what ss-TACE is, how it works, and why doctors use it. Learning about ss-TACE can help people with liver cancer understand this treatment choice.

ss-TACE is a very targeted form of TACE. It uses a tiny tube called a catheter to get the chemo right to the tumor’s blood vessels. This allows doctors to focus the treatment on the cancer while sparing more of the healthy liver tissue. Research shows ss-TACE may work better than regular TACE for certain patients.

This article will go over the key things to know about superselective TACE. It will look at what makes it different than regular TACE. It will also cover what types of liver cancer ss-TACE is used for. By the end, readers will understand who can benefit from this specialized treatment.

What Is Superselective Tace and How Does It Work?

TACE stands for transarterial chemoembolization. It is a treatment for liver cancer that cannot be removed with surgery. TACE delivers strong chemotherapy drugs right to the tumor. It also blocks off or “embolizes” the blood vessels feeding the tumor.

This cuts off the tumor’s blood supply and food source. The chemo and embolization work together to attack the cancer. TACE can help shrink or control tumors when surgery is not an option.

In regular TACE, the chemo goes into the main hepatic artery. This large blood vessel feeds the whole liver and both sides. With superselective TACE, doctors use a thinner, more flexible catheter. This lets them access smaller blood vessels closer to the tumor itself.

The catheter goes into tiny arteries called subsegmental branches. These feed just the part of the liver with the tumor. Once the catheter is positioned, chemo flows right to the tumor’s blood vessels. Then particles are injected to block the vessels and cut off the blood supply.

Since ss-TACE delivers chemo superselectively, more of it goes to cancer cells. Less reaches healthy parts of the liver. This helps limit damage to normal liver tissue. Doctors can also give higher chemo doses with ss-TACE versus regular TACE.

Why Is Superselective Tace Used?

Not all patients get ss-TACE. It is only used for certain types and stages of liver cancer. The tumor must be in a location suitable for superselective delivery. Patients also need good enough liver function to handle the procedure.

Here are the key requirements for ss-TACE treatment:

  • Type of cancer – ss-TACE is only used for hepatocellular carcinoma (HCC), the most common form of liver cancer.
  • Location – The tumor must be in the caudate lobe of the liver. This part is next to large blood vessels.
  • Size and spread – The tumor cannot have invaded any major branch of the portal or hepatic veins. There can be no cancer spread to other organs.
  • Surgery – The patient is not eligible for surgery to remove the tumor due to its location or size.
  • Liver function – Liver function must be well enough to tolerate ss-TACE. Poor liver function is a sign a patient may not tolerate it.
  • Prior Treatment – The patient should not have received prior radiation therapy to the liver area.

Overall the goal is to use ss-TACE for liver cancer not suitable for surgery but still confined to the liver. Patients need good enough liver function for this targeted chemo delivery.

What Are the Benefits of Superselective Tace?

Research suggests ss-TACE may offer some advantages over regular TACE:

  • Better targeting – More chemo reaches the tumor versus healthy liver tissue. This enhances anti-cancer effects.
  • Higher dose – Doctors can use higher chemo doses with ss-TACE given the targeted delivery.
  • Smaller particles – Tiny particles can be used to block smaller vessels feeding the tumor.
  • Fewer side effects – Limiting chemo exposure for the rest of the liver reduces damage and side effects.
  • Survival advantage – Studies show ss-TACE may extend survival time versus non-selective TACE.
  • Repeat procedures – The targeted approach allows ss-TACE to be repeated in some cases.
  • Guidelines – Cancer care guidelines say TACE should be superselective when possible for the best results.

While not a cure, ss-TACE may extend life or improve quality of life for the right patients. Talk to a liver doctor to see if it may help.

How Do Doctors Perform Superselective Tace?

ss-TACE takes place in an special x-ray room called an interventional radiology suite. It does not require major surgery. Patients are given medicine to relax but remain awake. Here are the main steps:

1. Catheter inserted – A thin, flexible catheter is inserted into an artery in the groin. The doctor threads this up to the hepatic artery.

2. Contrast injected – Contrast dye is injected to visualize the liver blood vessels on x-ray. This shows the tumor location.

3. Catheter positioned – Using x-ray guidance, the doctor moves the catheter into the subsegmental artery feeding the tumor.

4. Chemo injected – Once positioned, the chemotherapy drugs are slowly injected through the catheter to reach the tumor.

5. Embolization – Tiny particles are injected to lodget in the vessels and block blood flow to the tumor.

6. Repeat as needed – In some cases, steps can be repeated to target tumors in different arterial branches.

7. Catheter removal – Once complete, the catheter is withdrawn. Pressure is applied to the groin to prevent bleeding.

The procedure may take 1-2 hours depending on the complexity. Patients stay for a period of observation afterward before going home.

What Are Possible Side Effects of This Treatment?

As with any procedure, ss-TACE does have some possible side effects:

  • Liver damage – Even with superselective delivery, chemotherapy can damage liver cells.
  • Liver failure – There is a small risk of acute liver failure, especially for those with poor liver function.
  • Infection – An infection could develop where the catheter was inserted.
  • Bleeding – Some minor bleeding can occur. Serious internal bleeding is rare.
  • Blood cell counts – Chemo may lower blood cell counts for a period of time.
  • Nausea/vomiting – Mild nausea or vomiting may occur after treatment.
  • Fever – A mild fever from the embolization materials is common.
  • Pain – Some abdominal pain may occur but this is typically mild.

Doctors will monitor for any concerning side effects after the procedure. Alert them right away about any unusual symptoms. Avoid strenuous activity for about a week after ss-TACE.

What Questions Should I Ask My Doctor About Ss-Tace?

If your doctor recommends superselective TACE, make sure to ask important questions:

  • Why do you think I’m a good candidate?
  • How will you determine if my liver function is adequate?
  • What chemo drugs will you use? What are possible side effects?
  • Will I need just one session or multiple?
  • What happens if some tumors are not treatable this way?
  • What other treatment options do I have besides ss-TACE?
  • What results have you seen with ss-TACE for similar patients?
  • How might this treatment help my specific cancer situation?
  • How will we monitor my liver function during and after treatment?
  • What symptoms should I report to you right away?

Don’t hesitate to speak up with any other questions or concerns. Understanding the procedure will help you feel comfortable moving forward.


Superselective transarterial chemoembolization is an advanced option for treating liver tumors. A thin catheter delivers concentrated chemo right to the tumor’s blood vessels. It also cuts off their blood supply. This targeted approach helps maximize anti-cancer effects while protecting more of the healthy liver.

Though not a cure, ss-TACE may extend life or improve quality of life for those with specific types and stages of liver cancer. It is only suitable for tumors in certain locations without major vessel invasion. Patients also require adequate liver function to handle the chemo. Talk to your doctor to see if ss-TACE is appropriate for your specific liver cancer situation.

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