Combining transarterial chemoembolization (TACE) with systemic therapy significantly enhances outcomes for hepatocellular carcinoma patients with hepatic vein or inferior vena cava tumor thrombus.

• Median overall survival was 20.9 months with TACE vs. 14.3 months without (HR=0.65).
• Progression-free survival also favored TACE, at 10.7 months compared to 7.3 months (HR=0.67).

Adding TACE improves the objective response rate significantly, suggesting it should be considered in first-line treatment.

• 45.3% response rate with TACE vs. 28.8% without (p<0.001).