Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2005 Jul;242(1):36-42.
doi: 10.1097/01.sla.0000167925.90380.fe.

Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma: a prospective study

Affiliations
Clinical Trial

Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma: a prospective study

Guan-Tarn Huang et al. Ann Surg. 2005 Jul.

Abstract

Objective: To compare disease recurrence and survival among patients with small hepatocellular carcinoma after surgical resection or percutaneous ethanol injection therapy, 2 treatments that have not been evaluated with a prospective study.

Methods: A total of 76 patients were randomly assigned to 2 groups based on treatment; all had one or 2 tumors with diameter </=3 cm, with hepatitis without cirrhosis or Child class A or B cirrhosis without evident ascites or bleeding tendency.

Results: Follow-up ranged from 12 to 59 months. Among percutaneous injection patients, 18 had recurrence 1 to 37 months after treatment (true recurrence, 11; original safety margin inadequate, 3; limitation of imaging technology to detect tiny tumors, 4). Three injection therapy patients died of cancer 25, 37, and 57 months after treatment. For the surgical resection group, 15 had recurrence 2 to 54 months after treatment (true recurrence, 12; limitation of imaging, 2; neck metastasis, 1). Five resection patients died of cancer at 11, 20, 23, 26, and 52 months, respectively. By Cox regression model and Kaplan-Meier survival analysis, there is no statistical significance for recurrence and survival between treatment groups. However, tumor size larger than 2 cm and alpha-fetoprotein over 200 ng/mL correlated with higher recurrence rate, and Child class B liver cirrhosis correlated with shorter survival.

Conclusions: Percutaneous ethanol injection therapy appears to be as safe and effective as resection, and both treatments can be considered first-line options for small hepatocellular carcinoma.

PubMed Disclaimer

Figures

None
FIGURE 1. Survival and recurrence after randomization to surgical resection (SR) or percutaneous ethanol injection therapy (PEIT). Gray bars represent tumor-free intervals in months, and black bars indicate the point at which recurrence was detected (in months) and period of survival following detection. “x” shows when the patient died.

Comment in

References

    1. Sung JL, Wang TH, Yu JY. Clinical study on primary carcinoma of the liver in Taiwan. Am J Dig Dis. 1967;12:1036–1049. - PubMed
    1. Chen DS, Sheu JC, Sung JL, et al. Small hepatocellular carcinoma: a clinicopathological study in thirteen patients. Gastroenterology. 1982;83:1109–1119. - PubMed
    1. Sheu JC, Sung JL, Chen DS, et al. Early detection of hepatocellular carcinoma by real-time ultrasonography. Cancer. 1985;56:660–666. - PubMed
    1. Lee CS, Sheu JC, Wang M, et al. Long-term outcome after surgery for asymptomatic small hepatocellular carcinoma. Br J Surg. 1996;83:330–333. - PubMed
    1. Livraghi T, Giorgio A, Marin G, et al. Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology. 1995;197:101–108. - PubMed

Publication types

MeSH terms