REFERENCES
1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74:229-63.
2. Zheng RS, Chen R, Han BF, et al. [Cancer incidence and mortality in China, 2022]. Zhonghua Zhong Liu Za Zhi. 2024;46:221-31.
3. Rumgay H, Ferlay J, de Martel C, et al. Global, regional and national burden of primary liver cancer by subtype. Eur J Cancer. 2022;161:108-18.
4. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. J Hepatol. 2022;76:681-93.
5. Lanza C, Ascenti V, Amato GV, et al. All you need to know about TACE: a comprehensive review of indications, techniques, efficacy, limits, and technical advancement. J Clin Med. 2025;14:314.
6. Chen S, Peng Z, Zhang Y, et al. Lack of response to transarterial chemoembolization for intermediate-stage hepatocellular carcinoma: abandon or repeat? Radiology 2021;298:680-92.
7. Sun X, Wei T, Kang T, Zhang Y, Huang G. Meta-analysis of the value of albumin-bilirubin grading on changes in liver function and its prognostic assessment in patients with hepatocellular carcinoma treated with transhepatic arterial chemoembolization. World J Surg Oncol. 2025;23:361.
8. Zhou J, Sun H, Wang Z, et al. China liver cancer guidelines for the diagnosis and treatment of hepatocellular carcinoma (2024 Edition). Liver Cancer. 2025;14:779-835.
9. Vogel A, Chan SL, Dawson LA, et al. ; ESMO Guidelines Committee. Electronic address: [email protected]. Hepatocellular carcinoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2025;36:491-506.
10. Reig M, Sanduzzi-Zamparelli M, Forner A, et al. BCLC strategy for prognosis prediction and treatment recommendations: The 2026 update. J Hepatol. 2026;84:631-54.
11. Zhu H, Liu R, Jia Z, et al. Transarterial chemoembolization for hepatocellular carcinoma: Treatment algorithm proposed by Chinese College of Interventionalists (CCI). EngMedicine. 2024;1:100037.
12. Zhong BY, Fan W, Guan JJ, et al. Combination locoregional and systemic therapies in hepatocellular carcinoma. Lancet Gastroenterol Hepatol. 2025;10:369-86.
13. Sangro B, Kudo M, Erinjeri JP, et al. ; EMERALD-1 Investigators. Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma (EMERALD-1): a multiregional, randomised, double-blind, placebo-controlled, phase 3 study. Lancet. 2025;405:216-32.
14. Kudo M, Ren Z, Guo Y, et al. ; LEAP-012 investigators. Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma (LEAP-012): a multicentre, randomised, double-blind, phase 3 study. Lancet. 2025;405:203-15.
15. Zhu HD, Li HL, Huang MS, et al. ; CHANCE001 Investigators. Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001). Signal Transduct Target Ther. 2023;8:58.
16. Jin ZC, Chen JJ, Zhu XL, et al. ; CHANCE2201 Investigators. Immune checkpoint inhibitors and anti-vascular endothelial growth factor antibody/tyrosine kinase inhibitors with or without transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma (CHANCE2201): a target trial emulation study. EClinicalMedicine. 2024;72:102622.
17. Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35:1164-71.
18. Llovet JM, Real MI, Montaña X, et al. ; Barcelona Liver Cancer Group. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359:1734-9.
19. China NHCotPsRo. Guideline for the diagnosis and treatment of primary liver cancer (2024 edition). J Multidiscip Cancer Manag 2024;10:17-68. (in Chinese) Available from https://www.nhc.gov.cn/yzygj/c100068/202404/b12cab9adae7424493cd2d387f018367.shtml [accessed 29 July 2026].
20. Raoul JL, Gilabert M, Piana G. How to define transarterial chemoembolization failure or refractoriness: a European perspective. Liver Cancer. 2014;3:119-24.
21. Kudo M, Matsui O, Izumi N, et al. ; Liver Cancer Study Group of Japan. Transarterial chemoembolization failure/refractoriness: JSH-LCSGJ criteria 2014 update. Oncology. 2014;87:22-31.
22. Cheng AL, Amarapurkar D, Chao Y, et al. Re-evaluating transarterial chemoembolization for the treatment of hepatocellular carcinoma: consensus recommendations and review by an International Expert Panel. Liver Int. 2014;34:174-83.
23. Zhong B, Zhang S, Zhu H, Wang W, Ni C. ; Clinical Guidelines Committee of Chinese College of Interventionalists. Transarterial chemoembolization refractoriness in hepatocellular carcinoma: Chinese College of Interventionalists definition and consensus statement. Chin Med J 2024;137:2040-2.
24. Yang C, Luo YG, Yang HC, Yao ZH, Li X. Effects of early TACE refractoriness on survival in patients with hepatocellular carcinoma: a real-world study. J Hepatocell Carcinoma. 2022;9:621-31.
25. Li BR, Zhang LO. Research progresses in molecular mechanisms of TACE resistance of hepatocellular carcinoma. Chin J Interv Imaging Ther. 2025;22:425-8. (in Chinese).
26. Zhang S, Wang WS, Zhong BY, Ni CF. Subsequent treatment after transarterial chemoembolization failure/refractoriness: a review based on published evidence. J Clin Transl Hepatol. 2022;10:740-7.
27. Yu SCH, Chan L, Lee KF, et al. Ethiodized oil-based transarterial chemoembolization for hepatocellular carcinoma: randomized clinical trial of anhydrous cisplatin suspension versus cisplatin emulsion. Radiology. 2025;317:e242982.
28. Shang JN, Zhao ZW, Zheng X, et al. Clinical efficacy and safety of thermosensitive hydrogel in transcatheter arterial chemoembolization for the treatmentof primary liver cancer. J Med Imaging 2025;35:83-6. (in Chinese).
29. Ogasawara S, Chiba T, Ooka Y, et al. Efficacy of sorafenib in intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization. Oncology. 2014;87:330-41.
30. Arizumi T, Ueshima K, Minami T, et al. Effectiveness of sorafenib in patients with transcatheter arterial chemoembolization (TACE) refractory and intermediate-stage hepatocellular carcinoma. Liver Cancer. 2015;4:253-62.
31. Alharbi SR. Selective angiographic roadmap analysis (SARA) of hepatocellular carcinoma feeding arteries for transarterial chemoembolization. Diagnostics. 2025;15:2533.
32. Clinical Guidelines Committee of Chinese College of Interventionalists. [Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition)]. Zhonghua Yi Xue Za Zhi. 2026;106:1998-2021.
33. Wang K, Feng J, Yu H, et al. Transarterial chemoembolization plus atezolizumab and bevacizumab in patients with intermediate hepatocellular carcinoma: a single-arm, phase 2 trial. Signal Transduct Target Ther. 2025;10:328.
34. Peng Z, Fan W, Zhu B, et al. Lenvatinib combined with transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma: a phase III, randomized clinical trial (LAUNCH). J Clin Oncol. 2023;41:117-27.
35. Li W, Lu M, Yuan G, et al. Comparison of the efficacy and safety of TACE-HAIC-MTTs-ICIs and TACE-MTTs-ICIs in the hepatocellular carcinoma: a prognostic analysis based on the dynamic changes of serum AFP. Int J Surg. 2025;111:7041-52.
36. Zhang S, Zhong BY, Zhang L, Wang WS, Ni CF. Transarterial chemoembolization failure/refractoriness: a scientific concept or pseudo-proposition. World J Gastrointest Surg. 2022;14:528-37.
37. Gao X, Sun Y, Huang J, Xu L, Huang H, Yang Z. Adrenomedullin orchestrates treatment resistance in hepatocellular carcinoma via immune microenvironment remodeling. Front Genet. 2025;16:1721263.
38. Li J, Liu Y, Zheng R, Qu C, Li J. Molecular mechanisms of TACE refractoriness: directions for improvement of the TACE procedure. Life Sci. 2024;342:122540.
39. Liu CY, Wang MF, Xu XY, et al. Liver function dynamics in advanced hepatocellular carcinoma receiving immune checkpoint inhibitors and anti-vascular endothelial growth factor antibody/tyrosine kinase inhibitors with or without transarterial chemoembolization. Ther Adv Med Oncol. 2025;17:17588359251347363.
40. Li R, Liu J, Ye F, et al. Microbial metabolism dysfunction induced by transarterial chemoembolization aggravates postprocedural liver injury in HCC. J Hepatol. 2026;84:808-22.
41. Saito N, Tanaka T, Nishiohuku H, et al. Transarterial- chemoembolization remains an effective therapy for intermediate-stage hepatocellular carcinoma with preserved liver function. Hepatol Res. 2020;50:1176-85.
42. Hiraoka A, Kumada T, Kudo M, et al. ; Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics). Hepatic function during repeated TACE procedures and prognosis after introducing sorafenib in patients with unresectable hepatocellular carcinoma: multicenter analysis. Dig Dis. 2017;35:602-10.
43. Chan SL, Sun HC, Xu Y, et al. The Lancet Commission on addressing the global hepatocellular carcinoma burden: comprehensive strategies from prevention to treatment. Lancet. 2025;406:731-78.
44. Lim RY, Koh B, Ng CH, et al. ; Liver Cancer Research Network. Hepatocellular carcinoma surveillance and survival in a contemporary Asia-Pacific cohort. JAMA Netw Open. 2025;8:e2520294.
45. Kim BK, Shim JH, Kim SU, et al. Risk prediction for patients with hepatocellular carcinoma undergoing chemoembolization: development of a prediction model. Liver Int. 2016;36:92-9.
46. Wang Q, Xia D, Bai W, et al. ; China HCC-TACE Study Group. Development of a prognostic score for recommended TACE candidates with hepatocellular carcinoma: a multicentre observational study. J Hepatol. 2019;70:893-903.
47. Xia D, Bai W, Wang Q, et al. ; China HCC-TACE study group. Tumor burden with AFP improves survival prediction for TACE-treated patients with HCC: an international observational study☆. JHEP Rep. 2025;7:101216.
48. Han G, Berhane S, Toyoda H, et al. Prediction of survival among patients receiving transarterial chemoembolization for hepatocellular carcinoma: a response-based approach. Hepatology. 2020;72:198-212.
49. Sieghart W, Hucke F, Pinter M, et al. The ART of decision making: retreatment with transarterial chemoembolization in patients with hepatocellular carcinoma. Hepatology. 2013;57:2261-73.
50. Hucke F, Sieghart W, Pinter M, et al. The ART-strategy: sequential assessment of the ART score predicts outcome of patients with hepatocellular carcinoma re-treated with TACE. J Hepatol. 2014;60:118-26.
51. Chen L, Ni CF, Chen SX, et al. A modified model for assessment for retreatment with transarterial chemoembolization in Chinese Hepatocellular Carcinoma Patients. J Vasc Interv Radiol. 2016;27:1288-97.
52. Hucke F, Pinter M, Graziadei I, et al. How to STATE suitability and START transarterial chemoembolization in patients with intermediate stage hepatocellular carcinoma. J Hepatol. 2014;61:1287-96.
53. Adhoute X, Penaranda G, Naude S, et al. Retreatment with TACE: the ABCR SCORE, an aid to the decision-making process. J Hepatol. 2015;62:855-62.
54. Shen L, Zeng Q, Guo P, et al. Dynamically prognosticating patients with hepatocellular carcinoma through survival paths mapping based on time-series data. Nat Commun. 2018;9:2230.
55. Dang M, Wang S, Peng F, et al. Multiple features of cell-free mtDNA for predicting transarterial chemoembolization response in hepatocellular carcinoma. Hepatol Commun. 2025;9:e0652.
56. Wei R, Liu Z, Ju L, et al. Using machine learning to predict advanced-stage progression of intermediate-stage hepatocellular carcinoma after transarterial chemoembolization. Radiol Imaging Cancer. 2025;7:e250034.
57. Song L, Zhu C, Shi Q, et al. Gelation embolism agents suppress clinical TACE-incited pro-metastatic microenvironment against hepatocellular carcinoma progression. EBioMedicine. 2024;109:105436.
58. Gong F, Zheng L, Xu J, et al. Magnesium microspheres for enhanced transarterial chemoembolization therapy of hepatocellular carcinoma: from animal models to a pilot clinical study. Sci Adv. 2025;11:eadv0885.
59. Wu Z, Ouyang S, Gao J, et al. Role of radiomics-based multiomics panel in the microenvironment and prognosis of hepatocellular carcinoma. Acad Radiol. 2025;32:1961-70.
60. Wang G, Ding F, Chen K, et al. CT-based radiomics nomogram to predict proliferative hepatocellular carcinoma and explore the tumor microenvironment. J Transl Med. 2024;22:683.
