Significance of tumor vascularity as a predictor of long-term prognosis in patients with small hepatocellular carcinoma treated by percutaneous ethanol injection therapy.
OBJECTIVE
We estimated the significance of the vascularity of small hepatocellular carcinoma (HCC) as a predictor of long-term prognosis in patients treated with percutaneous ethanol injection therapy (PEIT/PEI).


METHODS
Fifty-four patients who have been followed-up in our hospital and who had HCC less than 20 mm in diameter were observed for 199 to 2074 days. Hepatic angiography (digital subtraction angiography; DSA and ultrasound angiography with intraarterial CO2 microbubbles; USAG) was performed before treatment in all cases, and the vascularity of the tumor was clinically evaluated. The survival rate was analyzed according to this vascularity.


RESULTS
Of the 54 tumors, 24 had tumor stain on DSA, while 30 did not, and 38 showed enhancement on USAG, while 16 did not. The 3- and 5-year survival rates were 48.7 and 34.1% and 89.7 and 69.7% of patients with negative staining HCC (p = 0.0723). The rates were 48.6 and 36.7%, respectively, of patients with positive enhancement HCC on USAG, and both rates were 85.7% of patients with negative enhancement HCC (p = 0.0231).


CONCLUSIONS
Tumor vascularity will play a role in the long-term prognosis of these patients with small HCC when they are treated with PEIT/PEI.
Toyoda
H
H
Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Kumuda
T
T
Nakano
S
S
Takeda
I
I
Sugiyama
K
K
Kiriyama
S
S
Sone
Y
Y
D000279:Administration, Cutaneous; D000368:Aged; D015901:Angiography, Digital Subtraction; D002245:Carbon Dioxide; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000175:diagnosis / Q000188:drug therapy*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005544:Forecasting; D006801:Humans; D007267:Injections; D008113:Liver Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D013194:Staining and Labeling; D016019:Survival Analysis; D013997:Time Factors; D014465:Ultrasonics
D002245:Carbon Dioxide; D000431:Ethanol