Percutaneous ethanol injection therapy in the treatment of hepatocarcinoma--results obtained from a series of 88 cases

Abstract

Aim: To assess the efficacy of Percutaneous Ethanol Injection Therapy (PEIT) for the treatment of hepatocarcinoma in a series of Romanian patients, and to compare it with previous studies.

Material and method: We retrospectively evaluated 88 patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC) treated by PEIT. Multiple sessions of PEIT were performed to treat a single nodule of 2-10 cm in diameter. The Child-Pugh classification was used for evaluating the severity of LC and the Okuda and Barcelona scores for HCC. The efficacy of PEIT was assessed by CT or MRI one month after the therapy. The patients' survival after PEIT was calculated starting from the first PEIT procedure until the moment of death or the end of study (2000-2005). We analyzed the main factors which influenced the survival of the treated patients.

Results: The global survival was 38.07+/-3.97 months, longer in patients with Child-Pugh A class, than in Child-Pugh B class (Log Rank 0.04). Patients with HCC less than 3 cm in diameter survived significantly longer than patients with tumors larger than 5 cm (Log Rank 0.007). Also, survival was better in the Barcelona A stage than in the Barcelona B and C stages (Log Rank 0.002) and in patients with alpha-fetoprotein less than 200 ng/l (Log Rank 0.002).

Conclusion: The main factors which influenced the survival of patients treated by PEIT were: the size of the HCC, the Child-Pugh class, the Barcelona stage and the level of alpha-fetoprotein at the time of initiation of therapy.