Percutaneous ethanol injection before liver transplantation in the hepatocellular carcinoma.
OBJECTIVE
The study evaluates the outcome of patients who performed orthotopic liver transplantation (LT) as treatment for hepatocellular carcinoma (HCC), with percutaneous ethanol injection (PEI) while on the waiting list, verifying the effectiveness of this treatment in producing tumor necrosis and avoiding dropout and identifying treatment-related complications.


METHODS
Medical records of 97 patients on the waiting list for LT at Hospital Clinic of Barcelona were examined. Sixty-two (56.3%) patients had been treated with PEI (group 1); 35 (31.8%) had not received any anti-tumor therapy before LT (group 2).


RESULTS
Complete necrosis of the tumor was observed in 38/59 (64.3%) patients. The presence of additional nodules in the explant and the diameter of the main tumor of group 1 was significantly lower than in group 2 (p = 0.002). Dropout related to tumor progression occurred in 4.8% and 8.5%, and tumor recurrence in 5% and 6.2% for groups 1 and 2, respectively. Major complications were not evidenced after 421 PEI sessions and there was no tumor implant in the needle traject.


CONCLUSIONS
In conclusion, the percutaneous treatment of HCC with PEI is a safe and effective method before the LT.
Department of Ultrasound and BCLC group Hospital Clinic of Barcelona, Liver Unit, Digestive Disease Institute, University of Barcelona, Postgraduate Program of Hepatology, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Brazil. fsba@terra.com.br
Fernanda
F
Branco
Concepció
C
Brú
Ramon
R
Vilana
Luis
L
Bianchi
Angelo
A
Alves de Mattos
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D000431:Ethanol / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local; D011300:Preoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014463:Ultrasonography; D014850:Waiting Lists
D000431:Ethanol