Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection.

Livraghi, Tito; Giorgio, Antonio; Marín, Gema; Salmi, Andrea; Sio, Ilario de; Bolondi, Luigi; Pompili, Maurizio; Brunello, F.; Lazzaroni, Sergio; Torzilli, Guido

doi:10.1148/radiology.197.1.7568806

Cited by 868 publications

(556 citation statements)

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“…Survival rates of patients treated with percutaneous ethanol injection have been reported to be 38-60% at 5 years [287][288][289][290]. Local tumor progression rates after percutaneous ethanol injection have been reported to be 6-31% depending on the size of tumor [288,289,291,292]. Percutaneous ethanol injection has been considered a safe procedure, with mortality and morbidity rates of 0-3.2% and 0-0.4%, respectively [289,291,293].…”

Section: Local Ablation Is a First-line Treatment Of Unresectable Smmentioning

confidence: 99%

“…Local tumor progression rates after percutaneous ethanol injection have been reported to be 6-31% depending on the size of tumor [288,289,291,292]. Percutaneous ethanol injection has been considered a safe procedure, with mortality and morbidity rates of 0-3.2% and 0-0.4%, respectively [289,291,293]. Percutaneous microwave coagulation, in which the cancer tissue is ablated by dielectric heat produced by microwave energy emitted from the inserted 16-gauge, bipolar-type electrode, was introduced into clinical practice in the 1990s and reported to improve local tumor control [283].…”

Section: Local Ablation Is a First-line Treatment Of Unresectable Smmentioning

confidence: 99%

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Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Section: Local Ablation Is a First-line Treatment Of Unresectable Smmentioning

confidence: 99%

Section: Local Ablation Is a First-line Treatment Of Unresectable Smmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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“…Radiofrequency waves , cryotherapy (Sotsky and Ravikumar, 2002), lasers (Vogl et al, 2004), microwave energy (Shibata et al, 2002), ethanol injection (Livraghi et al, 1995) and high-intensity focused ultrasound (HIFU) (Kennedy, 2005) have all been used to ablate tumours; however, HIFU remains the only modality to be completely extracorporeal.…”

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confidence: 99%

The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population

et al. 2005

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High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFUt Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.

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“…Ninety-five percent absolute ethanol is injected in and around the tumor in order to induce protein denaturation and small vessel thrombosis. The technique is inexpensive, and complications are rare (Livraghi et al, 1995;Di Stasi et al, 1997). Death due to treatment occurs in 0.009-0.1% of cases (Beaugrand et al, 2005).…”

Section: Percutaneous Ablationmentioning

confidence: 99%

New aspects of diagnosis and therapy of hepatocellular carcinoma

et al. 2006

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Hepatocellular carcinoma is one of the major cancer killers. It affects patients with chronic liver disease who have established cirrhosis, and currently is the most frequent cause of death in these patients. The main risk factors for its development are hepatitis B and C virus infection, alcoholism and aflatoxin intake. If acquistion of risk factors is not prevented and cirrhosis is established, the sole option to improve survival is to detect the tumor at an early stage when effective therapy may be indicated. Early detection plans should be based on hepatic ultrasonography every 6 months, whereas determination of tumor markers is not efficient. Upon detection of a hepatic nodule, there is a need to establish unequivocal diagnosis, either through biopsy or through the application of non-invasive criteria based on the specific radiology appearance of the tumor: fast arterial uptake of contrast followed by venous washout. Effective treatment for liver cancer includes surgical resection, liver transplantation and percutaneous ablation. These options provide a high rate of complete responses and are assumed to improve survival that should exceed 50% at 5 years. If the tumor is diagnosed at an advanced stage, the sole option that improves survival is transarterial chemoembolization. Ongoing research should further advance the time at diagnosis and identify new and effective options targeting molecular pathways governing tumor progression.

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Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection.

Abstract: PEI proved safe, effective, and repeatable and had a low cost. Survival after PEI was comparable to that after surgery, probably because of a balancing between greater radicality of surgery and absence of early mortality and liver damage of PEI.

Cited by 868 publications

References 0 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population

New aspects of diagnosis and therapy of hepatocellular carcinoma

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