Hepatocellular carcinoma: treatment with a combination of transcatheter arterial chemoembolization and transportal ethanol injection.
OBJECTIVE
To evaluate the efficacy and complications of transportal ethanol injection (TPEI) combined with transcatheter arterial chemoembolization to achieve complete tumor necrosis and prevent intrahepatic metastases in patients with hepatocellular carcinoma (HCC).


METHODS
In 13 patients with HCC, chemoembolization was performed with injection of a mixture of iodized oil and doxorubicin hydrochloride followed by administration of gelatin sponge; 1-4 weeks later, TPEI was performed with percutaneous transhepatic portography. Ethanol (15-65 mL) was injected in the portal veins around the tumor until occlusion.


RESULTS
TPEI was successfully performed in all patients. Two patients subsequently underwent surgery; their tumors were resected completely. Two died of hepatic failure. Seven of the nine other patients showed no recurrence or intrahepatic metastasis during follow-up (7-42 months). Histologic examination, performed in nine patients, showed complete necrosis of tumor and scattered or severe necrosis of surrounding tissues.


CONCLUSIONS
This treatment has a strong anticancerous effect and is expected to be used in treatment of properly selected patients with HCC.
Yamakado
K
K
Department of Radiology, Mie University School of Medicine, Japan.
Hirano
T
T
Kato
N
N
Takeda
K
K
Nakagawa
T
T
Takase
K
K
Nakano
T
T
Murayama
T
T
Matsuda
A
A
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D011172:Portography / Q000379:methods; D015641:Radiography, Interventional; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
D000431:Ethanol; D004317:Doxorubicin