Percutaneous hot saline injection therapy: effectiveness in large hepatocellular carcinoma.
OBJECTIVE
To report on the efficacy of percutaneous hot saline injection therapy (PSIT) in the treatment of large hepatocellular carcinoma (HCC).


METHODS
Twenty-nine patients with 31 HCCs underwent PSIT. Physiologic saline was mixed with contrast medium and Lipiodol; this mixture was boiled and injected into the tumor. Mean tumor diameter was 7.0 cm. Initial regression rates were evaluated at 3-month interval with computed tomography (CT) and alpha-fetoprotein level measurement. Cumulative survival rates were calculated with the Kaplan-Meier method. Multivariate analysis using Cox's proportional hazard regression model was performed to determine the significant prognostic factors.


RESULTS
Initial regression rate for all tumors at a 3-month interval was 42% (13 of 31 tumors) and the median survival was 10.0 months (range, 3.0-36.0 months). The significant prognostic factors were encapsulated tumors, tumors less than 10 cm in diameter, tumors with even saline dispersion, tumors with initial regression at 3-month follow-up, and TNM stage II or III rather than IV.


CONCLUSIONS
PSIT is a feasible alternative treatment for a large HCC when transcatheter arterial chemoembolization is not feasible or has failed.
Yoon
H K
HK
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Song
H Y
HY
Sung
K B
KB
Chung
Y H
YH
Lee
Y S
YS
Suh
D J
DJ
Lee
S G
SG
Auh
Y H
YH
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003287:Contrast Media; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature; D006801:Humans; D015552:Injections, Intralesional; D007459:Iodized Oil; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
D000970:Antineoplastic Agents; D003287:Contrast Media; D000509:alpha-Fetoproteins; D012965:Sodium Chloride; D007459:Iodized Oil