Document Detail


Large infiltrative hepatocellular carcinomas: treatment with percutaneous intraarterial ethanol injection alone or in combination with conventional percutaneous ethanol injection.
MedLine Citation:
PMID:  15564388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively evaluate patients' tolerance and the effectiveness of percutaneous intraarterial ethanol injection (PIAEI), alone or combined with conventional percutaneous ethanol injection (PEI), for treatment of advanced hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Neither institutional review board approval nor informed consent was required for this retrospective study; however, all patients had given their consent to be treated with PIAEI. Fourteen men and four women with cirrhosis and HCC who were ineligible for conventional curative treatment (largest tumor diameter, 35-90 mm; mean, 52 mm +/- 16 [standard deviation]) and whose supplying arteries were visible on computed tomographic (CT) and color Doppler ultrasonographic (US) images were treated with US-guided PIAEI-either alone or combined with PEI. Twelve patients had infiltrative tumors, and six had nodular tumors. Four patients had portal venous tumor involvement. Tumor necrosis and recurrence were evaluated with CT, and 1- and 2-year survival rates were evaluated with Kaplan-Meier analysis. RESULTS: In four patients, the main tumor was treated with PIAEI only, and in 14 patients, the main tumor was treated with combined PIAEI and PEI. One patient died of myocardial infarction before CT evaluation. Tumor necrosis was complete in 15 (88%) and incomplete in two (12%) of 17 patients. Results of subsequent surgery performed in three patients confirmed the radiologic findings: complete tumor necrosis in two patients and incomplete necrosis in one patient. Two severe PIAEI-related complications occurred: liver abscess, which resolved, and fatal acute pancreatitis. During the follow-up period (mean, 15 months +/- 6.7), six patients died owing to recurrent HCC, and 10 patients were alive with no detectable tumor after a mean follow-up period of 18 months +/- 11. One- and 2-year survival rates were 76.6% and 44.5%, respectively. CONCLUSION: For patients with advanced HCC who are ineligible for other curative options, PIAEI could be an effective treatment, despite the associated risk of severe complications.
Authors:
Olivier Seror; Giselle N'Kontchou; Djamel Haddar; Marius Dordea; Yves Ajavon; Nathalie Ganne; Jean Claude Trinchet; Michel Beaugrand; Nicolas Sellier
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Publication Detail:
Type:  Journal Article     Date:  2004-11-24
Journal Detail:
Title:  Radiology     Volume:  234     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-24     Completed Date:  2005-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-309     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2004.
Affiliation:
Departments of Radiology and Hepatogastroenterology, Hôpital Jean Verdier, Assistance Publique Hôpitaux de Paris, avenue du 14 Juillet, 93143 Bondy Cedex, France. olivier.seror@jvr.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carcinoma, Hepatocellular / radiography,  therapy*
Chemoembolization, Therapeutic / methods*
Ethanol / administration & dosage*
Female
Humans
Injections, Intra-Arterial
Injections, Intralesional
Liver Neoplasms / radiography,  therapy*
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Interventional*
Chemical
Reg. No./Substance:
64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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