title: Hepatocellular carcinoma: treatment with a combination therapy of transcatheter arterial embolization and percutaneous ethanol injection.
abstract: In an attempt to obtain complete tumor necrosis in large hepatocellular carcinoma (HCC) lesions, the authors studied the clinical and histologic findings of a new combination therapy, percutaneous ethanol injection (PEI) with transcatheter arterial embolization (TAE) (pretreatment with TAE and subsequent PEI) in 15 patients with a single, large (3.0-9.0 cm in diameter), encapsulated lesion of HCC. Two weeks after TAE, PEI was performed under ultrasound guidance. A total of four to 11 injections were administered at a rate of one injection twice a week. During the follow-up period (range, 7-23 months), all lesions were reduced in size and no evidence of HCC was present at contrast material-enhanced computed tomography or angiography in nine of 11 patients who did not subsequently undergo surgery. Six patients had a follow-up of 1 year or more, for a 1-year survival rate of 100%. Four patients subsequently underwent surgical resection; complete necrosis of the tumor was observed in all four. The authors conclude that a combination of PEI and TAE is an appropriate treatment for patients with large, encapsulated HCC lesions who are poor surgical risks.
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: H
authors.initials: H
authors.lastname: Okazaki
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
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 / Q000175:diagnosis / Q000628:therapy*; D002404:Catheterization; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007267:Injections / Q000379:methods; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000431:Ethanol