Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization.
The therapeutic effectiveness of a new combination therapy--pretreatment with transcatheter arterial embolization (TAE) and subsequent percutaneous ethanol injection (PEI)--for solitary large (> 3.0 cm in diameter) primary hepatocellular carcinoma lesions was compared with that of TAE alone. With TAE alone, a partial response of the tumor was seen in only 10% of the patients, and the 1-, 2-, and 3-year survival rates were calculated to be 68%, 37%, and 0%, respectively. Histologic examination of specimens obtained at hepatectomy showed that TAE alone caused complete necrosis in only 20% of the tumors. In contrast, PEI combined with TAE significantly (P < .05) increased the partial response rate (45%) and significantly (P < .01) prolonged the 1-, 2-, and 3-year survival rates (100%, 85%, and 85%, respectively). Combination therapy caused complete histologic necrosis in 83% of the tumors. It also was significantly (P < .05) better than TAE alone in terms of rate of primary tumor recurrence during follow-up.
Tanaka
K
K
Third Department of Internal Medicine, Yokohama City University School of Medicine, Japan.
Nakamura
S
S
Numata
K
K
Okazaki
H
H
Endo
O
O
Inoue
S
S
Takamura
Y
Y
Sugiyama
M
M
Ohaki
Y
Y
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy*; D002406:Catheterization, Peripheral; D002423:Cause of Death; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D015552:Injections, Intralesional; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012074:Remission Induction; D015996:Survival Rate
D000431:Ethanol; D007459:Iodized Oil; D004317:Doxorubicin