title: Ethanol injection is highly effective for hepatocellular carcinoma smaller than 2 cm.
abstract: OBJECTIVE
  To analyze the long-term prognosis in a cohort of western cirrhotic patients with single hepatocellular carcinoma treated with ethanol injection.
  
  
  METHODS
  One-hundred forty-eight patients with solitary hepatocellular carcinoma were enrolled. The tumor diameter was lower than 2 cm in 47 patients but larger in the remaining 101 patients. The impact of some pre-treatment clinical and laboratory parameters and of tumor recurrence on patients' survival was assessed.
  
  
  RESULTS
  Among the pre-treatment parameters, only a tumor diameter of less than 2 cm was an independent prognostic factor of survival. The occurrence of new nodules in other liver segments and the neoplastic portal invasion were linked to a poorer prognosis at univariate analysis. Patients with a single hepatocellular carcinoma smaller than 2 cm showed a better 5-year cumulative survival (73.0% vs 47.9%) (P = 0.009), 3-year local recurrence rate (29.1% vs 51.5%) (P = 0.011), and 5-year distant intrahepatic recurrence rate (52.9% vs 62.8%) (P = 0.054) compared to patients with a larger tumor.
  
  
  CONCLUSIONS
  The 5-year survival rate of patients with single hepatocellular carcinoma < 2 cm undergoing ethanol injection is excellent and comparable to that achieved using radiofrequency ablation.
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, Rome, Italy. mpompili@rm.unicatt.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Erica
authors.initials: E
authors.lastname: Nicolardi
authors.forename: Valeria
authors.initials: V
authors.lastname: Abbate
authors.forename: Luca
authors.initials: L
authors.lastname: Miele
authors.forename: Laura
authors.initials: L
authors.lastname: Riccardi
authors.forename: Marcello
authors.initials: M
authors.lastname: Covino
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Matthaeis
authors.forename: Antonio
authors.initials: A
authors.lastname: Grieco
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
authors.forename: Gian Ludovico
authors.initials: GL
authors.lastname: Rapaccini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D015331:Cohort Studies; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000431:Ethanol