Prognosis of hepatocellular carcinoma with no tumor stain treated by percutaneous ethanol injection.
OBJECTIVE
Some hepatocellular carcinoma nodules do not show tumor stain by hepatic angiography or enhanced computed tomography. The aim of this study was to clarify the prognosis of hepatocellular carcinoma with no tumor stain treated by percutaneous ethanol injection.


METHODS
Twenty patients who had hepatocellular carcinoma with no tumor stain were treated by percutaneous ethanol injection between January 1990 and June 1998. No patients had received any anticancer treatments before percutaneous ethanol injection. Recurrence-free survival, predictive factors for recurrence and recurrent patterns were examined. Overall survival was also examined.


RESULTS
Ten of the 20 patients showed intrahepatic recurrences in other parts of the treated lesions, although no local recurrence was observed. Median recurrence-free survival time, 1-, 3- and 5-year recurrence-free survival rates were 2.8 years, 66%, 43% and 22%, respectively. A serum alpha-fetoprotein level of 20 ng/mL or less was the only factor that was significantly associated with prolonged recurrence-free survival. Of the 12 recurrent nodules in 10 patients, 9 occurred in different segments of the treated lesion and 8 were histopathologically confirmed to be well-differentiated hepatocellular carcinoma. Overall survival rates 1, 3, and 5 years after percutaneous ethanol injection were 100%, 82%, and 75%, respectively.


CONCLUSIONS
Percutaneous ethanol injection may be useful for the treatment of hepatocellular carcinoma with no tumor stain.
Ueno
H
H
Department of Internal Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. hiueno@ncc.go.jp
Okada
S
S
Okusaka
T
T
Ikeda
M
M
Tanaka
N
N
Sakamoto
M
M
Yoshimori
M
M
D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000098:blood supply / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D000431:Ethanol