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The long term efficacy of combined transcatheter arterial embolization and percutaneous ethanol injection in the treatment of patients with large hepatocellular carcinoma and cirrhosis
Author(s) -
Tanaka Katsuaki,
Nakamura Saburo,
Numata Kazushi,
Kondo Masaaki,
Morita Katsumi,
Kitamura Takehiko,
Saito Satoru,
Kiba Takayoshi,
Okazaki Hiroshi,
Sekihara Hisahiko
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980101)82:1<78::aid-cncr9>3.0.co;2-g
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , percutaneous ethanol injection , lesion , gastroenterology , embolization , survival rate , survival analysis , percutaneous , stage (stratigraphy) , arterial embolization , surgery , radiofrequency ablation , ablation , paleontology , biology
BACKGROUND The long term efficacy of combination therapy with transcatheter arterial embolization (TAE) followed by percutaneous ethanol injection (PEI) was studied in patients with large primary hepatocellular carcinoma (HCC) tumors and cirrhosis. METHODS The series included 83 patients with large unresectable HCC lesions, the largest of which was greater than 3 cm in largest dimension. Fifty‐five had a solitary lesion and 28 had multiple (2 or 3) lesions. All patients were treated with both TAE and PEI and their survival rates were determined. RESULTS The 3‐, 5‐, and 7‐year calculated survival rates for the patients were be 68%, 35%, and 14%, respectively. The number of lesions (solitary vs. multiple), the stage of cirrhosis (Child's Class A vs. Class B or C), and the size of the largest lesion (3‐5 cm in largest dimension compared with > 5 cm) significantly affected the survival rate ( P < 0.05 to P < 0.01, log rank test). The 3‐, 5‐, and 7‐year survival rates of the Child's Class A patients who had a 3‐5 cm solitary lesion (n = 22) were 100%, 75%, and 27%, respectively. The Cox proportional hazards model showed the stage of cirrhosis and size of the largest lesion to be independently associated with survival. No serious complications occurred during or after treatment. CONCLUSIONS Combination therapy with TAE and PEI is an effective and safe treatment that may improve the long term survival of patients with cirrhosis associated with large HCC lesions, and survival after this combination therapy may be comparable to that after surgery. Cancer 1998;82:78‐85. © 1998 American Cancer Society.