title: Transarterial Ethanol Ablation for Unresectable Hepatocellular Carcinoma: Analysis of Clinical and Tumor Outcomes.
abstract: OBJECTIVE
  To evaluate survival, tumor response, and treatment toxicity of transarterial ethanol ablation (TEA) in patients with unresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  This prospective study involved 186 patients (146 men and 40 women; median age, 65 y [interquartile range, 57-72.3 y]). Of 186 patients, 146 (78.5%) were hepatitis B virus carriers, 18 (9.7%) were hepatitis C virus carriers, 82 (44.1%) had tumors ≥ 5 cm, and 43 (23.1%) had multifocal tumors. Overall survival (OS), complete response (CR) by European Association for the Study of the Liver criteria, time to progression (TTP), progression-free survival (PFS), and treatment toxicities were evaluated. Univariate and multivariate analyses for prognostic factors of OS were performed.
  
  
  RESULTS
  Median OS was 25.7 months (95% confidence interval [CI], 20.9-30.5) and varied significantly between Child-Pugh A and B (28.7 mo vs 13.4 mo, P < .001), and Barcelona Clinic Liver Cancer A and B or C (37.1 mo vs 17.7 mo, P = .001). Prognostic factors for longer OS were solitary tumor, tumor size < 5 cm, > 1 treatments, and CR of all tumors at 6 months. TTP was 9.1 months (95% CI, 6.9-11.3). PFS was 8.4 months (95% CI, 7.1-9.7). CR occurred in 69.1% (159/230) of lesions and 48.9% (88/180) of patients at 6 months. Any one symptom of the postembolization syndrome of grade 2 severity occurred in < 22% (41/186) of patients. No treatment-related hepatitis or death occurred within 30 days. Transient respiratory decompensation occurred in three patients (1.6% [3/186]), and alcoholic intoxication occurred in one patient (0.5% [1/186]).
  
  
  CONCLUSIONS
  TEA appears to be safe and effective for local control of HCC.
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR; Department of Vascular and Interventional Radiology Foundation Clinical Science Center, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR. Electronic address: simonyu@cuhk.edu.hk.
authors.forename: Simon Chun Ho
authors.initials: SC
authors.lastname: Yu
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Edwin Pun
authors.initials: EP
authors.lastname: Hui
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Peggy
authors.initials: P
authors.lastname: Tang
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Stephen Ka Chi
authors.initials: SK
authors.lastname: Chan
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Charmant Cheuk Man
authors.initials: CC
authors.lastname: Chu
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Joyce Wai Yi
authors.initials: JW
authors.lastname: Hui
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Stephen Lam
authors.initials: SL
authors.lastname: Chan
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Kit Fai
authors.initials: KF
authors.lastname: Lee
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Paul Bo San
authors.initials: PB
authors.lastname: Lai
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Room 2A061, 2/F, Main Clinical Block and Trauma Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, New Territories, Hong Kong SAR.
authors.forename: Winnie
authors.initials: W
authors.lastname: Yeo
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000401:mortality; D000368:Aged; D015901:Angiography, Digital Subtraction; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D007261:Infusions, Intra-Arterial; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000431:Ethanol