title: Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization.
abstract: 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.
authors.affiliation: Third Department of Internal Medicine, Yokohama City University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Numata
authors.forename: H
authors.initials: H
authors.lastname: Okazaki
authors.forename: O
authors.initials: O
authors.lastname: Endo
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: Y
authors.initials: Y
authors.lastname: Takamura
authors.forename: M
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Y
authors.initials: Y
authors.lastname: Ohaki
mesh_terms: 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
chemical_list: D000431:Ethanol; D007459:Iodized Oil; D004317:Doxorubicin