Interventional treatment for liver cancer, also called hepatic artery chemoembolization (TACE), is a minimally invasive treatment method in which a 3-5 mm incision is made on the skin, and a tube is inserted into the hepatic artery through the femoral artery of the thigh or the radial artery of the wrist to inject chemotherapeutic drugs and vascular embolic agents into the tumor vessels without surgery. Patients may feel confused when they see this, because interventional surgery blocks the arteries of liver in order to kill liver cancer cells, won’t the normal liver be affected by ischemia and necrosis? In fact, the principle of interventional treatment to control liver cancer is that 90% of the nutrient vessels of primary liver cancer come from hepatic artery, while the nutrient vessels of normal liver tissues come from portal vein of the liver. We can “starve” the tumor to death. Interventional treatment for liver cancer has been carried out for more than several decades since the 1970s, and its efficacy in the treatment of liver cancer has been fully affirmed. The advantages of interventional treatment for liver cancer include: 1. selective infusion of chemotherapy drugs through hepatic artery, the concentration of chemotherapy drugs is tens of times higher than that of intravenous chemotherapy, but the toxicity is less than that of systemic chemotherapy, and blocking the blood supply of tumor through embolic agents such as iodine oil and gelatin sponge, which is effective in a two-pronged way. Patients with good efficacy after interventional surgery have rapid decrease of methemoglobin, shrinkage of tumor and pain relief; 2. Interventional surgery is minimally invasive, local anesthesia is sufficient, and the surgical incision is only a few millimeters, which can be performed even for elderly and frail patients. 3. Most patients recover quickly after interventional surgery, and the treatment is well tolerated and can be repeated in about 4-6 weeks; 4. The cost of interventional treatment is low, and some large hepatocellular carcinomas that cannot be surgically resected can be surgically resected after the tumor shrinks through interventional treatment; which patients are suitable for interventional treatment? 1.Patients with middle and late stage primary liver cancer that cannot be surgically resected. As liver cancer starts insidiously and has no symptoms in early stage, most patients have large tumor diameter when diagnosed and are mostly accompanied by intrahepatic vascular invasion or distant metastasis, which lose the treatment opportunity of surgical resection. These patients are the main group of patients who receive interventional treatment. 2.Patients with metastatic liver cancer, such as patients with liver metastasis of colon cancer, liver metastasis of gastric cancer and pancreatic cancer, intrahepatic tumors over 5 cm or multiple tumors that cannot be surgically resected, local interventional therapy combined with chemotherapy and targeted therapy can significantly improve the tumor control rate. 3. Patients who cannot or do not want to undergo liver cancer surgery due to other reasons (such as advanced age, severe cirrhosis, etc.) although they can be surgically resected. How many times of liver cancer interventional therapy should be done? What is the course of treatment? Liver cancer is not so easy to deal with. After one interventional treatment, imaging (CT or MRI) is needed in 4-6 weeks, and some patients with small tumor load can be well controlled and do not need further treatment. For patients with larger tumors and a larger number of tumors with liver cancer, especially giant tumors, one interventional drug fill cannot fill the whole tumor tissue and needs to be injected in a course of treatment. The tumor cells that are on the verge of “starvation” but not completely necrosis are very cunning and will secrete growth factors that promote “long blood vessels” to grow new nutritious blood vessels to ensure survival. In this case, the patient needs to repeat the interventional treatment to replenish drugs for liver cancer from the newly grown blood vessels, and then block the newly grown blood vessels, similar to “patching”. Therefore, the number of interventions required for each patient depends on the size and number of tumors, tumor survival after treatment, and the condition of new blood vessels, and there is no fixed course of treatment. There is no fixed course of treatment. The need for repeated interventions should be determined by the treating physician based on the postoperative review. For patients with hepatocellular carcinoma that cannot be removed surgically, interventional therapy is currently the most widely used treatment method. As a local treatment option for tumor, it needs to be combined with different therapeutic measures such as targeted therapy, immunotherapy and radiotherapy to better improve the efficacy of comprehensive treatment.