Comparison of percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma

Abstract

Background/aims: To assess whether ultrasound (US)-guided percutaneous acetic acid injection is more effective than percutaneous ethanol injection in the treatment of small hepatocellular carcinoma (HCC).

Methodology: sixty patients with 1 to 4 HCC smaller than 3 cm entered a randomized controlled trial from August 1993 to September 1995. Thirty one and 29 patients were treated by percutaneous acetic acid injection using 50% acetic acid and percutaneous ethanol injection using absolute ethanol, respectively. There were no significant differences in clinical characteristics and biochemical data between the two groups.

Results: All original tumors were treated successfully by the chosen therapy. However, local recurrence occurred in 8% of the 38 tumors treated with percutaneous acetic acid injection and 37% of the 35 tumors treated with percutaneous ethanol injection P>0.001). The 1- and 2-year survival rates were 100% and 92% with percutaneous acetic acid injection and 83% and 63% with percutaneous ethanol injection (p=0.0017). Multivariate analysis of prognostic factors revealed that treatment was an independent predictor of survival.

Conclusion: percutaneous acetic acid injection is more effective than percutaneous ethanol injection.