title: Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for the treatment of large hepatocellular carcinoma: local therapeutic effect and long-term survival rate.
abstract: The aim of our study was to investigate local therapeutic effects and long-term results of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of large hepatocellular carcinoma (HCC). Eight-six patients (67 males and 19 females, age range 48-75 years, mean age 65.1 years) with Child-Pugh class A (n = 48) or B (n = 38) liver cirrhosis and a large HCC (main tumor 3.1-8 cm in diameter with no more than two daughter nodules) were enrolled in a prospective study. All patients underwent a single TACE session followed by PEI. Follow-up ranged from 4 to 65 months (mean 27.8 months, median 26 months). No major complication occurred. The local therapeutic effect, as assessed on the basis of findings at CT and MR imaging, was complete response in 71 of 86 patients (82 %) and partial response in 15 of 86. Overall survival rates by the Kaplan-Meier method were 92 % at 1 year, 83 % at 2 years, 69 % at 3 years, 58 % at 4 years, and 47 % at 5 years. Survival of Child-Pugh A patients (75 % at 3 years and 59 % at 5 years) was significantly longer (p < 0.01) than that of Child-Pugh B patients (61 % at 3 years and 35 % at 5 years). Combined TACE and PEI is an effective treatment for large HCC.
authors.affiliation: Division of Diagnostic and Interventional Radiology, Department of Oncology, University of Pisa, Via Roma 67, I-56 125 Pisa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Lencioni
authors.forename: A
authors.initials: A
authors.lastname: Paolicchi
authors.forename: M
authors.initials: M
authors.lastname: Moretti
authors.forename: F
authors.initials: F
authors.lastname: Pinto
authors.forename: N
authors.initials: N
authors.lastname: Armillotta
authors.forename: M
authors.initials: M
authors.lastname: Di Giulio
authors.forename: A
authors.initials: A
authors.lastname: Cicorelli
authors.forename: F
authors.initials: F
authors.lastname: Donati
authors.forename: D
authors.initials: D
authors.lastname: Cioni
authors.forename: C
authors.initials: C
authors.lastname: Bartolozzi
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002406:Catheterization, Peripheral; D016461:Chemoembolization, Therapeutic; D018450:Disease Progression; D015251:Epirubicin / Q000008:administration & dosage*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008103:Liver Cirrhosis / Q000145:classification; D017093:Liver Failure / Q000209:etiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D000431:Ethanol; D015251:Epirubicin