Long-term follow-up arterial chemoembolization combined with transportal ethanol injection used to treat hepatocellular carcinoma.
OBJECTIVE
This study was undertaken to evaluate the long-term efficacy of transcatheter hepatic arterial chemoembolization (TACE) combined with transportal ethanol injection (TPEI) in patients with hepatocellular carcinoma (HCC).


METHODS
Twenty-six patients with unresectable HCC underwent TPEI 2-6 weeks after TACE. The size of the main tumor ranged from 2.0 to 9.0 cm (mean, 4.5 cm). Ethanol (10-65 mL) was injected via a percutaneous transhepatic approach into the portal vein, perfusing the segment to be treated. TACE was repeated after TPEI in 18 patients.


RESULTS
The combined therapy was technically successfully in all 26 cases; however, irreversible hepatic failure developed in two (8%) patients. Recurrent disease occurred either from the treated lesion (four patients) or apart from the treated liver segment (five patients) in nine of 21 patients (43%) followed up for a mean of 34 months. The survival rates were 87%, 72%, 72%, 63%, 51, and 51% at 1, 2, 3, 4, 5, and 6 years, respectively. Resected and autopsied specimens showed complete necrosis in seven of nine main lesions and severe parenchymal damage in the treated liver segment.


CONCLUSIONS
In selected patients, combined treatment with TACE and TPEI is safe and effective, decreasing recurrence rate in the treated segment, and resulting in a 51% 6-year survival.
Yamakado
K
K
Department of Radiology, Mie University School of Medicine, Tsu, Japan.
Nakatsuka
A
A
Tanaka
N
N
Matsumura
K
K
Takase
K
K
Takeda
K
K
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / 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 / Q000401:mortality / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011169:Portal Vein; D015996:Survival Rate; D013997:Time Factors
D000970:Antineoplastic Agents; D000431:Ethanol; D004317:Doxorubicin