title: Evaluation of transarterial chemoembolization combined with percutaneous ethanol ablation for large hepatocellular carcinoma.
abstract: OBJECTIVE
  To assess the effects of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol ablation (PEA) in patients with large hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 63 patients with unresectable large HCC were treated with TACE followed by PEA. The largest dimension of the tumors ranged from 5.3 cm to 17.8 cm. The survival rates, acute effects, toxicity and prognostic factors were analyzed.
  
  
  RESULTS
  The cumulative survival rates at 1, 3 and 5 years were 59.4%, 28.4% and 15.8%, respectively (a median survival of 27.7 mo). Tumor area was reduced by more than 50% in 30 (47.6%) cases. In 56 cases with increased α-fetoprotein (AFP) values, AFP level was declined by more than 75%. The combined therapy was generally well tolerated. Only two patients died from variceal bleeding associated with the therapy. The Cox proportional hazards model showed that the number of tumors, the tumor margin and the ethanol dose were independent prognostic factors.
  
  
  CONCLUSIONS
  The combined TACE and PEA therapy is a promising approach for unresectable large HCC.
authors.affiliation: State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-Sen University, 615 East Dongfeng Road, Guangzhou, Guangdong Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Yang-Kui
authors.initials: YK
authors.lastname: Gu
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Fan
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Huang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D000431:Ethanol