[Therapy of malignant hepatic tumors using percutaneous hot saline injections. Feasibility study and preliminary results].
OBJECTIVE
To investigate the feasibility and the results of percutaneous hot saline injection therapy (PSIT) of liver tumors.


METHODS
Eight patients with hepatocellular carcinoma (11 nodules), 1 with cholangiocarcinoma and 1 with a metastasis from colon cancer underwent PSIT. The patients were selected according to variable criteria; thus, each patient was considered apart. A boiling saline solution was injected into the hepatic lesions through a needle like those commonly used for percutaneous ethanol injection (PEI). The results were assessed with US, CT, angiography, the measurement of tumor marker levels, the histopathologic examination of needle biopsy material, resected specimens, explanted liver material and follow-up.


RESULTS
PSIT was more easily performed and altogether better accepted than PEI; in particular, pain immediately regressed upon infusion interruption. For this reason and for the atoxicity of the injected liquid, relatively large lesions could be treated with a greater volume per session and fewer sessions than with PEI. Treatment outcome was positive in all patients, except for the cholangiocarcinoma patient who required surgery. The only major complication was moderate peritoneal bleeding in a patient with severe coagulopathy.


CONCLUSIONS
PSIT can be considered a useful tool for the local treatment of hepatic tumors. Its systematic use to treat hepatocellular carcinoma must be proceeded by further comparative studies with PEI.
Veltri
A
A
Istituto di Radiologia, Università di Torino.
Martina
C
C
Bonenti
G
G
Dore
D
D
Cirillo
S
S
Grosso
M
M
Fava
C
C
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001650:Bile Duct Neoplasms / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012965:Sodium Chloride / Q000008:administration & dosage*; D013696:Temperature; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000431:Ethanol; D012965:Sodium Chloride
Terapia dei tumori epatici maligni mediante iniezione percutanea di soluzione fisiologica bollente. Studio di fattibilità e risultati preliminari.