Percutaneous ethanol injection for small hepatocellular carcinoma: therapeutic efficacy based on 20-year observation.
OBJECTIVE
To evaluate the therapeutic efficacy of percutaneous ethanol injection (PEI) for patients with < or = 3 lesions of small (< or = 3 cm diameter) hepatocellular carcinoma (HCC).


METHODS
PEI was applied to 270 patients with small HCC as the first-line treatment option during a 20-year period.


RESULTS
(1) There was no treatment-related deaths, and only 2.2% of severe complications; (2) PEI induced a complete response of all HCCs according to CT evaluation performed within one month after the procedure, and the local recurrence rate at 3 years was 10%; (3) the overall 3- and 5-year survival rates after treatment were 81.6 and 60.3%, respectively, but the rates were higher, 87.3 and 78.3%, in Child A patients with a solitary tumor < or = 2 cm in diameter; (4) factors significantly influencing survival were liver function (P = 0.0033) and serum alpha-fetoprotein level (P = 0.0014), and (5) the recurrence rate at remote sites in the liver was lower in patients with HCC < or = 2 cm (P = 0.0395) and in those with a solitary HCC (P < 0.0001) according to Cox's proportional hazard model. (6) Radiofrequency ablation would not have been performed in approximately 25% of these patients.


CONCLUSIONS
PEI is considered a reliable treatment for small HCC in terms of safety and efficacy.
Ebara
Masaaki
M
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba-shi, Chiba 260-8670, Japan. ebara@faculty.chiba-u.jp
Okabe
Shinichiro
S
Kita
Kazuhiko
K
Sugiura
Nobuyuki
N
Fukuda
Hiroyuki
H
Yoshikawa
Masaharu
M
Kondo
Fukuo
F
Saisho
Hiromitsu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000009:adverse effects; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D000431:Ethanol