Table 4. . Synopsis of principal guidelines recommendations and contraindications for transarterial chemoembolization in patients with hepatocellular carcinoma.

Organization	Extrahepatic metastasis	Vascular invasion	Liver function	Tumor extension
EASL-EORTC	Contraindication	Contraindication	Child-Pugh A or B7 without ascites. Performance status: 0	Multinodular (BCLC B stage)
NCCN	Contraindication	Contraindicated in case of main portal vein thrombosis	Child-Pugh A or B Bilirubin <3 mg	No limit (unresectable or nontransplantable patients)
APASL	Contraindication	TACE is admitted is case of invasion of hepatic/portal vein branches	Child-Pugh A or B	Tumor >5 cm or >three tumors that are unresectable Early stage in whom RFA cannot be performed
JSH	Contraindication	TACE is admitted in case of minor portal vein thrombosis. HAIC also in case of main portal branch invasion	Child-Pugh A or B Child-Pugh C is not an absolute contraindication (experimental treatment in patients meeting Milan criteria when hepatic encephalopathy and intractable ascites are absent and bilirubin is less than 3 mg/dl)	First choice in patients with up to three nodules In ≤three nodules >3cm is a resection’s alternative First-line therapy for downstaging tumors that exceed the criteria for transplantation
AISF	Contraindication	Peripheral, segmental portal invasion is not an absolute contraindication	Child-Pugh A or B7 Performance status: 0 or 1	EASL and also early-stage HCC, if surgical or ablative techniques are not applicable

AISF: Italian Association for the Study of the Liver; APASL: Asian-Pacific Association for the Study of the Liver; BCLC: Barcelona Clinic for Liver Cancer; EASL: European Association for Study of Liver; EORTC: European Organization for Research and Treatment of Cancer; HAIC: Hepatic arterial infusion chemotherapy; HCC: Hepatocellular carcinoma; JSH: Japanese Society of Heptology; NCCN: National Comprehensive Cancer Network; RFA: Radiofrequency ablation; TACE: Transarterial chemoembolization.