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Cochin Hospital · AP-HP · Université Paris Cité
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Cochin AP-HP

Hepatocellular Carcinoma (HCC) — Locoregional Treatments

Interventional Radiology · Cochin Hospital AP-HP · Paris

️ ri.cch@aphp.fr +33 1 58 41 46 12
IR Home›Hepatocellular Carcinoma (HCC) — Locoregional Treatments
🏥 Liver Cancer · Oncology

Hepatocellular Carcinoma (HCC) — Interventional Treatments

TACE · DEB-TACE · Y90 Radioembolization · RFA · Microwave · guidage scanner per-procédure · MDT · Paris Cochin AP-HP

Overview

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Interventional radiology provides highly effective locoregional treatments including transarterial chemoembolization (TACE), radioembolization (Y90), and percutaneous tumour ablation. These can be used as bridge to transplantation, downstaging prior to resection, or as definitive treatment in non-surgical candidates.

At Cochin AP-HP, all cases are discussed in our hepatology multidisciplinary team (MDT) including hepatologists, liver surgeons, oncologists, and interventional radiologists. We have the guidage scanner per-procédure with haute résolution scanner haute résolution scanner — unique technology for per-procedural imaging and personalised dosimetry.

At a glance — key figures

Interventional radiology offers a full range of treatments for hepatocellular carcinoma depending on the BCLC stage: percutaneous ablation, chemoembolization (TACE), and Y90 radioembolization.

CriterionData
Early stage (BCLC 0-A)Percutaneous ablation — results comparable to surgical resection for tumours < 3 cm
Intermediate stage (BCLC B)Chemoembolization (TACE), repeatable
Advanced / portal thrombosisY90 radioembolization, feasible even with portal vein thrombosis
Decision-makingAlways discussed at a multidisciplinary tumour board
CostCovered by French national health insurance at Cochin AP-HP — no out-of-pocket fees.

Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.

Treatment options

💊 TACE / DEB-TACE

Standard of care for intermediate-stage HCC (BCLC B). Selective intra-arterial injection of chemotherapy + embolization. DEB-TACE (drug-eluting beads) reduces systemic toxicity. 70–80% objective response.

⚛️ Y90 Radioembolization (SIRT)

TheraSphere® microspheres loaded with yttrium-90. Preferred for HCC with portal vein thrombosis or large tumour burden. Personalised dosimetry. Cochin is a reference centre for Y90.

🌡️ RFA / Microwave Ablation

Curative-intent ablation for HCC ≤5 cm. Local anaesthesia + sedation or general anaesthesia. 90–95% local control for lesions ≤3 cm. guidage scanner per-procédure guidance for lesions not visible on ultrasound.

🤝 MDT & Bridge to transplantation

All cases discussed in MDT. TACE and ablation used as bridge to liver transplantation (Milan/UCSF criteria maintenance) or downstaging to transplant eligibility (UNOS criteria).

FAQs

TACE combines chemotherapy and embolization to starve and poison the tumour. Y90 delivers targeted internal radiation via microspheres. Y90 is preferred when portal vein thrombosis is present or when TACE has failed. Both are complementary and can be combined.
For small HCC (≤3 cm), percutaneous ablation (RFA or microwave) achieves 90–95% local control and is considered curative-intent. Larger tumours typically require TACE, Y90, or combined approaches as part of a multimodal strategy.
Yes. All procedures at Cochin AP-HP are covered by the French national health insurance. No patient fees.

Frequently asked questions

Depending on the stage: percutaneous ablation (radiofrequency, microwave, cryoablation) for early-stage tumours, chemoembolization (TACE) for intermediate stage, and Y90 radioembolization including in the presence of portal vein thrombosis.
Through the BCLC staging system and a multidisciplinary team meeting involving hepatologists, oncologists, surgeons and interventional radiologists, taking into account tumour size and number, liver function and general condition.
Yes. Ablation, TACE and Y90 are widely used as bridging treatments to control the tumour while a patient waits for liver transplantation.
Yes. At Cochin AP-HP (a French public hospital), this procedure is covered by national health insurance with no out-of-pocket fees. Contact ri.cch@aphp.fr or +33 1 58 41 46 12.

Related pages

Why this page is trustworthy

Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.

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