title: No treatment, resection and ethanol injection in hepatocellular carcinoma: a retrospective analysis of survival in 391 patients with cirrhosis. Italian Cooperative HCC Study Group.
abstract: OBJECTIVE
  This retrospective study was undertaken to obtain information relevant to the therapeutic strategy in single hepatocellular carcinoma associated with Child's A and B cirrhosis.
  
  
  METHODS
  From a total of 1108 consecutive patients with hepatocellular carcinoma, 391 patients with single, small (< or = 5 cm) hepatocellular carcinoma (260 in Child A class and 131 in Child B class) were observed: 120 were treated by surgical resection, 155 by percutaneous ethanol injection and 116 were untreated. The end point of the study was 3-year survival. The log rank test was used to compare survival among the different groups.
  
  
  RESULTS
  In the Child A group the cumulative 3-year survival was 79% for surgery, 71% for percutaneous ethanol injection and 26% for no treatment (p < 0.001 for surgery versus no treatment, p < 0.001 for percutaneous ethanol injection vs no treatment). In patients comparable to the surgical group, i.e. potentially operable, survival was 80% for percutaneous ethanol injection and 30% for no treatment. In the Child B group the 3-year survival was 40% for surgery, 41% for percutaneous ethanol injection and 13% for no treatment (p < 0.01 for surgery vs no treatment and p < 0.001 for percutaneous ethanol injection vs no treatment).
  
  
  CONCLUSIONS
  Surgery and percutaneous ethanol injection improve survival in single hepatocellular carcinoma associated with Child A and B cirrhosis compared to untreated patients in the same Child class. A controlled study to identify factors affecting the choice of treatment is justified.
authors.affiliation: Serv. Radiologia, Hospital of Vimercate, Milano, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Livraghi
authors.forename: L
authors.initials: L
authors.lastname: Bolondi
authors.forename: L
authors.initials: L
authors.lastname: Buscarini
authors.forename: M
authors.initials: M
authors.lastname: Cottone
authors.forename: A
authors.initials: A
authors.lastname: Mazziotti
authors.forename: A
authors.initials: A
authors.lastname: Morabito
authors.forename: G
authors.initials: G
authors.lastname: Torzilli
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000431:Ethanol