Percutaneous injection therapy for hepatocellular carcinoma in patients with chronic renal insufficiency.
OBJECTIVE
Percutaneous injection therapy using acetic acid or pure ethanol is effective for hepatocellular carcinoma (HCC). However, its efficacy in HCC patients with coexisting chronic renal insufficiency (CRI), defined as a serum creatinine level of 1.5 mg/dl or above, is not known. This study compared the survival in HCC patients with and without CRI undergoing percutaneous injection therapy.


METHODS
A total of 172 patients (129 male; age 67 +/- 10 years) during a 4-year period were included. Thirty-five of these patients had CRI (creatinine level 2.7 +/- 1.8 mg/dl) before treatment Fourteen patient- and tumour-related parameters were included for survival analysis.


RESULTS
The mean follow-up period was 24 +/- 9 (range 4-40) months. Seven (20%) and 39 (28%) patients in the groups with and without CRI, respectively, died. There was no significant survival difference in patients with and without CRI. The cause of death was related to renal failure in two (29%) patients in the former group and one (3%) patient in the latter group. For the patients with CRI, the presence of ascites and a serum creatinine level of 2.3 mg/dl or above were poor prognostic factors in the univariate analysis; the latter was the only independent factor predicting a poor survival by the Cox multivariate proportional model.


CONCLUSIONS
CRI does not affect overall survival in HCC patients undergoing percutaneous injection therapy. However, a serum creatinine level of 2.3 mg/dl or above is an independent poor prognostic predictor among patients with existing CRI.
Huo
Teh-Ia
TI
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China. tihuo@vghtpe.gov.tw
Huang
Yi-Hsiang
YH
Wu
Jaw-Ching
JC
Lee
Pui-Ching
PC
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D019342:Acetic Acid / Q000008:administration & dosage; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001201:Ascites / Q000150:complications; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000431:Ethanol; D003404:Creatinine; D019342:Acetic Acid