To assess the efficacy of ultrasound (US)-guided percutaneous
acetic acid (in concentrations of 15%, 20%, 30%, 40%, and 50%) injection for small
hepatocellular carcinomas (HCCs) for long-term prognosis, percutaneous
acetic acid injection using 15% to 50%
acetic acid was performed in 91 patients with one to four HCCs smaller than 3 cm during the past 6.5 years. During the series of treatment sessions for each patient, the same concentration of
acetic acid was used. All
tumors could be treated successfully with percutaneous
acetic acid injection despite the differences in
acetic acid concentration used. The number of treatment sessions to treat similar size of
tumor was less when the higher concentration of
acetic acid was used. No serious complications occurred as a direct sequela to percutaneous
acetic acid injection. None of the
tumor treated regrew. The 1-, 2-, 3-, 4-, and 5-year survival rates for 91 patients were 95%, 87%, 80%, 63%, and 49%, respectively. The 1-, 2-, 3-, 4-, and 5-year
cancer-free survival rates of these patients were 83%, 54%, 50%, 37%, and 29%, respectively. Both liver function and size of
tumor affected both survival rate and
cancer-free survival rate significantly, but the number of
tumors did not. The concentration of
acetic acid did not affect the survival rate. Percutaneous
acetic acid using 15% to 50%
acetic acid will be effective
therapy for small HCCs for long-term prognosis.