Korean J Radiol.  2006 Sep;7(3):187-192. 10.3348/kjr.2006.7.3.187.

Long-term Results of Percutaneous Ethanol Injection for the Treatment of Hepatocellular Carcinoma in Korea

• Sung YM
• Choi D
• Lim HK
• Lee WJ
• Kim SH
• Kim MJ
• Paik SW
• Yoo BC
• Koh KC
• Lee JH
• Choi MS

• KMID: 1114351
• DOI: http://doi.org/10.3348/kjr.2006.7.3.187

Abstract

OBJECTIVE
To evaluate the long-term follow-up results of percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in Korea. MATERIALS AND METHODS: Sixty-eight nodular HCCs initially detected in 64 patients, were subjected to US-guided PEI as a first-line treatment. Long-term survival rates, local tumor progression rates, and complications were evaluated, as were the influences of tumor size and Child-Pugh class on these variables. RESULTS: No major complications occurred. The overall survival rates of the 64 patients at three and five years were 71% and 39%, and their cancer-free survival rates were 22% and 15%, respectively. The overall survival rate of patients with a small HCC (< or = 2 cm) was significantly higher (p = 0.014) than that of patients with a medium-sized HCC (< or = 2 cm). The overall survival rate of patients with Child-Pugh class A was significantly higher (p = 0.049) than that of patients with Child-Pugh class B. Of 59 cases with no residual tumor, local tumor progression was observed in ablation zones in 18, and this was not found to be significantly influenced by tumor size or Child-Pugh class. CONCLUSION: The results of our investigation of the long-term survival rates of PEI in HCC patients in Korea (a hepatitis B virus-endemic area) were consistent with those reported previously in hepatitis C endemic areas. Patients with a smaller tumor or a better liver function exhibited superior survival rates.

Keyword

Liver, neoplasms; Liver neoplasms, therapy; Alcohol ablation

MeSH Terms

Treatment Outcome
Survival Rate
Survival Analysis
Risk Factors
Risk Assessment/*methods
Prognosis
Middle Aged
Male
Longitudinal Studies
Liver Neoplasms/*drug therapy/*mortality
Korea/epidemiology
Injections, Subcutaneous
Incidence
Humans
Female
Ethanol/*administration & dosage
Disease-Free Survival
Carcinoma, Hepatocellular/*drug therapy/*mortality
Antineoplastic Agents/administration & dosage
Adult

Figure

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  Fig. 1 The cumulative overall and cancer-free survival curves of our 64 study subjects with hepatocellular carcinoma, who treated by percutaneous ethanol injection.

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  Fig. 2 Cumulative survival curves of the 64 hepatocellular carcinoma patients after percutaneous ethanol injection treatment, according to tumor size. The survival rates of patients with a hepatocellular carcinoma of ≤ 2 cm in diameter (n = 39, black line) were determined to be significantly higher (p = 0.014, log-rank test) than those of patients with as hepatocellular carcinoma of ≤ 2 cm in diameter (n = 25, gray line).

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  Fig. 3 The cumulative survival curves of 55 hepatocellular carcinoma patients after percutaneous ethanol injection treatment, with respect to the Child-Pugh classification of the clinical stage of coexistent cirrhosis of the liver. The survival rates of class-A patients (n = 32, black line), and class-B patients (n = 23, gray line) were significantly different (p = 0.049, log-rank test).

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