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While the ability of trans-arterial http://www.selleck.cn/products/MK-1775.html chemoembolization (TACE) to achieve objective tumour response has been confirmed in a randomized controlled trial [66], its effectiveness in preventing drop-outs from waiting list is still unclear. The most complete metanalysis performed on this topic concludes that there is insufficient evidence that TACE, prior to LT for HCC, decreases drop-out rates on the waiting list [67] (low quality grade C recommendation [68]). Defining whether there is a survival benefit related to any pre-LT therapy in patients with good prognosis (within MC) remains hard to demonstrate, because the impact on survival of bridging therapies is not clearly established. Similarly, response to pretransplant therapies as http://www.selleckchem.com/PD-1-PD-L1.html a positive prognostic indicator in favour of a higher chance of post-transplant survival has not been proven yet. In a recent study, there was a marked survival benefit according to pretransplant response to TACE even though subgroup analysis showed that these benefits were only seen in patients whose tumours met the MC (true bridging) [69]. As the study was not comparing treated patients versus nontreated patients, it could not be stated if TACE had a real efficacy on post-transplant survival or if response to TACE was a surrogate marker of tumour behaviour. On the contrary, post-TACE tumour necrosis has been suggested to be related to higher chances of tumour post-transplant recurrence [70]. A recent meta-analysis of TACE as a bridge to transplantation highlighted that there is insufficient evidence to support the use of TACE prior to LT, as it did not seem to improve long-term survival [67]. Again, a clear answer on the possible benefit of pretransplant treatment of HCC will only be assessed through prospective trials, in which the http://www.selleckchem.com/products/Adriamycin.html existing differences among Centres with respect to on-list waiting-time for patients with HCC will have to be routed within accepted limits [56]. The prognostic effect of RFA as a bridge to transplantation has not been clearly defined, as only observational cohort studies have been reported [61�C64]. However, effectiveness of RFA in obtaining a complete tumour necrosis for T2 nodules with a diameter of