Previous research revealed that HCC exhibiting a tumor necrosis or fibrosis ratio of more than 90% following TACE typically displays homogeneity and high differentiation, with residual tumor cells predominantly characterized by poor differentiation and insensitivity to hypoxia.22 Concurrently, patients who do not achieve CR after TACE have higher levels of serum vascular endothelial growth factor and hypoxia-inducible factor-1α (HIF-1α). This evidence concerns the gene HIF1A and neoplasm.