Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients

Ebara, Masaaki; Ohto, Masao; Sugiura, Norío; Kita, K; Yoshikawa, Masaharu; Okuda, Kunio; Kondo, Fukuo; Kondō, Yōichirō

doi:10.1111/j.1440-1746.1990.tb01115.x

Cited by 290 publications

(151 citation statements)

References 23 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…87 Percutaneous alcohol injection is effective in tumors less than 3 cm in size but is far less successful for larger tumors. [88][89][90] Other treatment modalities, such as chemotherapy and tumor embolization, may be useful in individual patients but have not been shown to improve survival in patients with HCC. 90,91 The early results of liver transplantation for nonresectable HCC were quite discouraging.…”

Section: Hepatobiliary Malignanciesmentioning

confidence: 99%

Liver transplantation

Carithers

2000

Liver Transpl

View full text Add to dashboard Cite

Liver transplantation has revolutionized the care of patients with end-stage liver disease. Liver transplantation is indicated for acute or chronic liver failure from any cause. Because there are no randomized controlled trials of liver transplantation versus no therapy, the efficacy of this surgery is best assessed by carefully comparing postoperative survival with the known natural history of the disease in question. The best examples of this are in primary biliary cirrhosis and primary sclerosing cholangitis, for which well-validated disease-specific models of natural history are available. There are currently relatively few absolute contraindications to liver transplantation. These include severe cardiopulmonary disease, uncontrolled systemic infection, extrahepatic malignancy, severe psychiatric or neurological disorders, and absence of a viable splanchnic venous inflow system. One of the most frequently encountered contraindications to transplantation is ongoing destructive behavior caused by drug and alcohol addiction. The timing of the surgery can have a profound impact on the mortality and morbidity of patients undergoing liver transplantation. Because of the long waiting lists for donor organs, the need to project far in advance when transplantation might be required has proven to be one of the greatest challenges to those treating patients with end-stage liver disease. Three important questions must be addressed in a patient being considered for liver transplantation: (1) when should the patient be referred for possible transplantation? (2) when should the patient be listed for transplantation? and (3) when is the patient too sick to have a reasonable chance of surviving the perioperative period?

show abstract

Section: Hepatobiliary Malignanciesmentioning

confidence: 99%

Liver transplantation

Carithers

2000

Liver Transpl

View full text Add to dashboard Cite

show abstract

“…However, many patients have poor hepatic reserve owing to underlying chronic liver disease; therefore, only 5% to 40% of the patients with HCCs are candidates for hepatectomy. 4 Various local ablation therapies such as percutaneous ethanol injection 5,6 or percutaneous radiofrequency ablation (RFA) have been proposed as nonsurgical treatment options for small-sized HCCs, and excellent survival rates have been reported with these treatments. 7,8 Complete necrosis was achieved in 76% to 100% of the treated small-sized HCCs.…”

mentioning

confidence: 99%

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Morimoto

Numata

Kondou

et al. 2010

Cancer

287

View full text Add to dashboard Cite

BACKGROUND:To improve the efficacy of radiofrequency ablation (RFA) for the treatment of intermediate-sized hepatocellular carcinomas (HCCs), the authors compared RFA combined with transcatheter arterial chemoembolization (TACE) to RFA alone. METHODS: The authors randomly assigned 37 patients with solitary HCCs (diameter, 3.1-5.0 cm in the greatest dimension) to 2 groups: the TACE-RFA group, in which the patients received TACE followed by RFA on the same day, and the RFA group, in which the patients received only RFA. RESULTS: Technical success was achieved after 1.4 AE 0.5 RFA sessions in the RFA group and after 1.1 AE 0.2 RFA sessions in the TACE-RFA group (P < .01). The mean diameters of the longer and shorter axes of the RFA-induced ablated areas were 50 AE 8.0 mm and 41 AE 7.1 mm, respectively, in the RFA group and 58 AE 13.2 mm and 50 AE 11.3 mm, respectively, in the TACE-RFA group; the mean diameters of the shorter axes were significantly different (P ¼ .012). The rates of local tumor progression at the end of the third year in the RFA and TACE-RFA groups were 39% and 6%, respectively (P ¼ .012). The 3-year survival rates of the patients in the RFA and TACE-RFA groups were 80% and 93%, respectively (P ¼ .369). CONCLUSIONS: In patients with intermediate-sized HCCs, RFA combined with TACE is more effective than RFA alone for extending the ablated area in fewer treatment sessions and for decreasing the local tumor progression rate. Cancer 2010;116:5452-60.

show abstract

“…Percutaneous ethanol injection (PEI) is now widely carried out for small HCC. [15][16][17][18][19][20][21] The effect of PEI is almost comparable with that of surgical resection. 5,6,[16][17][18][19] However, a large number of treatment sessions are required [15][16][17][18][19][20] and recurrence after treatment is very common.…”

mentioning

confidence: 99%

“…[15][16][17][18][19][20][21] The effect of PEI is almost comparable with that of surgical resection. 5,6,[16][17][18][19] However, a large number of treatment sessions are required [15][16][17][18][19][20] and recurrence after treatment is very common. [17][18][19][20][21] In the course of development of US-guided percutaneous injection of a material to kill cancer cells, we took up acetic acid that has a strong tissue penetrating capabilities as it dissolves lipids and extracts collagen.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma

et al. 1998

View full text Add to dashboard Cite

To assess whether ultrasound-guided percutaneous acetic acid injection is superior to percutaneous ethanol injection in the treatment of small hepatocellular carcinoma (HCC), 60 patients with one to four HCCs smaller than 3 cm were entered onto a randomized controlled trial. Thirty-one and 29 patients, respectively, were treated by percutaneous acetic acid injection using 50% acetic acid or by percutaneous ethanol injection using absolute ethanol. There were no significant differences in age, sex ratio, Child-Pugh class, size of tumors, or number of tumors between the two groups. When there was no evidence of viable HCC from biopsy, plain and helical dynamic computed tomography, or angiography, the treatment was considered successful and was discontinued. All original tumors were treated successfully by either therapy. However, 8% of 38 tumors treated with percutaneous acetic acid injection and 37% of 35 tumors treated with percutaneous ethanol injection developed a local recurrence (P F .001) during the follow-up periods of 29 ؎ 8 months and 23 ؎ 10 months, respectively. The 1-and 2-year survival rates were 100% and 92% in percutaneous acetic acid injection and 83% and 63% in percutaneous ethanol injection (P ‫؍‬ .0017). A multivariate analysis of prognostic factors revealed that treatment was an independent predictor of survival. The risk ratio of percutaneous acetic acid injection versus percutaneous ethanol injection was 0.120 (range, 0.027-0.528; P ‫؍‬ .0050). In conclusion, percutaneous acetic acid injection is superior to percutaneous ethanol injection in the treatment of small HCC. (HEPATOLOGY 1998;27:67-72.)Hepatocelluar carcinoma (HCC) is one of the major malignancies with poor prognosis in eastern Asia, especially China, Japan, Taiwan, Singapore, and Korea, as well as Sub-Saharan Africa 1 ; the estimated incidence is approximately 1,250,000 deaths per year worldwide. 2 The early detection strategies for HCC have increased the number of small resectable HCCs in regions where they are endemic. [3][4][5] The survival rates reported after resection have improved in the last decade, mainly because of the increasingly smaller sizes of resected tumors. 4-9 Some surgical teams have thus achieved a 50% 5-year rate of survival in patients with small, asymptomatic HCCs. 5,6 However, resection is possible in a small proportion of patients because of the underlying advanced cirrhosis. Orthotopic liver transplantation is also an effective treatment for small, unresectable HCCs, but potential recipients far outnumber donors.Such difficulty in the management of HCC prompted the development of other potentially curative therapeutic modalities such as transcatheter hepatic arterial embolization (TAE) 13,14 and ultrasound (US)-guided percutaneous injection of materials that will kill cancer cells. [15][16][17][18][19][20][21][22] The latter is indicated for both hypervascular and hypovascular HCCs, whereas TAE is only for hypervascular HCCs; small HCCs are frequently hypovascular. Percutaneous ethanol injection (PEI) is...

show abstract

Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients

Cited by 290 publications

References 23 publications

Liver transplantation

Liver transplantation

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Prospective randomized controlled trial comparing percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma

Contact Info

Product

Resources

About