title: Continuous albendazole therapy in alveolar echinococcosis: long-term follow-up observation of 20 cases.
abstract: Twenty patients with primary hepatic alveolar echinococcosis were treated with continuous long-term albendazole at a dose of 20 mg/kg/d for an average of 5.7 years (1.5-13.5 years) and were followed up for an average of 12.7 years (4.1-13.5 years). The therapeutic effects were evaluated by clinical, laboratory (haemogram, liver function tests), ultrasonography and computed tomography (CT) examinations. The CT pattern of hepatic lesions was classified into three types: solid form (5 cases), pseudocystic form (6 cases) and 'geographic map' (mixed) form (9 cases). Short-term results were encouraging. Jaundice and haemoptysis disappeared within 1 month of starting treatment, and hemiparesis in a patient with cerebral metastases also gradually improved. Treatment was less effective in two patients with advanced disease. On long-term follow-up, three patients were apparently cured, and the remaining 17 patients showed a good initial response, but recurrence occurred in 13 patients (65%). Therapeutic outcome was favourable with the solid form, but poor with the pseudocystic form. The mixed form was a transitional phase and slowly progressive. Involvement of the porta hepatis was the cause of various complications with high morbidity and mortality. Five patients (25%) died during the period of observation, the 10-year survival rate being, therefore, 75%.
authors.affiliation: Institute of Infectious and Parasitic Diseases, The First Affiliated Hospital, Chongqing University of Medical Science, Chongqing, P.R.C. 400016.
authors.forename: Yue Han
authors.initials: YH
authors.lastname: Liu
authors.forename: Xiao Gen
authors.initials: XG
authors.lastname: Wang
authors.forename: Jin Song
authors.initials: JS
authors.lastname: Gao
authors.forename: Yun
authors.initials: Y
authors.lastname: Qingyao
authors.forename: John
authors.initials: J
authors.lastname: Horton
mesh_terms: D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000923:Anticestodal Agents / Q000627:therapeutic use*; D002681:China; D004334:Drug Administration Schedule; D004444:Echinococcosis, Hepatic / Q000188:drug therapy* / Q000401:mortality; D048210:Echinococcus multilocularis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000923:Anticestodal Agents; D015766:Albendazole