Chemoembolization with Degradable Starch Microspheres (DSM-TACE): expanding indications in HCC multidisciplinary tumor board

The role of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) management has changed over the last twenty years. There been a trend towards an overall decline TACE procedures, but with more aggressive approach, repeating multiple sessions case tumor response. survival treated patients was prolonged because better patient selection and advancements techniques aimed at preserving liver function. At present, is approved by International Guidelines also outside BCLC intermediate stage after evaluation multidisciplinary board (MDTB), permitting customized treatment for every patient. An alternative therapeutic strategy represented hepatic Degradable Starch Microspheres (DSM-TACE), which based on chemotherapeutic effect rather than ischemic damage to tumor, requiring cycles treatment. higher safety profile DSM-TACE broadened indications waiting transplantation (with bridging or downstaging intention), high risk failure ineligible systemic therapies. This review summarises scientific publications supporting use illustrates its depending disease from Interventional Radiologist’s perspective.