Who is a good candidate for TACE, and who should avoid it?

TACE is primarily indicated for patients with unresectable hepatocellular carcinoma (HCC) or liver metastases that are confined to the liver, with preserved liver function (Child-Pugh class A or B). It is also used as a bridge to liver transplantation or to downstage tumors for surgical resection. Contraindications include decompensated liver cirrhosis (Child-Pugh class C), extensive portal vein thrombosis, severe renal impairment, active infections, or poor performance status. Patients with extrahepatic metastases or severely compromised liver function are generally not suitable candidates.