Percutaneous Ethanol Injection Therapy in 47 Cirrhotic Patients With Hepatocellular Carcinoma 5 Cm or Less: A Long‐term Result

Abstract

SUMMARYTo elucidate the long‐term results of percutaneous ethanol injection (PEI) for hepatocellular carcinoma (HCC), 47 cirrhotic patients with HCC ≤5 cm after PEI were analysed. Thirty‐two of the patients were male. The age range was 37‐68 years. Thirty‐nine patients were seropositive either for hepatitis B surface antigen or antihepatitis C virus antibody. There were a total of 61 tumours, including solitary tumours in 35 patients, double tumours in 10 and triple tumours in two. The size of the main tumour was ≤3 cm in 29 patients and more than 3 cm in 18 patients. Seventeen, 27 and three patients were in Child's class A, B and C respectively; 5‐10 ml 95% ethanol was injected into the tumour every three to seven days until the echogenicity of the tumour changed to a hyperechoic or heterogeneous one. A booster PEI was given in 34 (56%) lesions with viable tumour, which was detected by dynamic computed tomography. The one, two, three and and four‐year survival rates were 85%, 75%, 61% and 39% respectively for all patients. Good liver reserve significantly improved the survival rate (p<0.01, Child's class A and B vs Child's class C). The one, two, three and four‐year recurrence rates were 24%, 55%, 69% and 79% for all patients. HCC recurred more frequently in patients with multiple tumours (p<0.02).