Treatment of hypervascular small hepatocellular carcinoma with ultrasound-guided percutaneous acetic acid injection: comparison with segmental transcatheter arterial embolization.

Abstract

OBJECTIVE:

To compare the efficacy of ultrasound-guided percutaneous acetic acid injection and segmental transcatheter arterial embolization for hypervascular small hepatocellular carcinoma.

METHODS:

The prognosis of 40 patients with one to three angiographically hypervascular hepatocellular carcinoma smaller than 3 cm in diameter treated with either percutaneous acetic acid injection (25 patients) or transcatheter arterial embolization (15 patients) during the past 4.5 yr were analyzed retrospectively.

RESULTS:

After initial therapy, none of 25 patients treated with percutaneous acetic acid injection developed ascites, whereas 5 of 15 (33%) patients treated with transcatheter arterial embolization developed it (p < 0.01). All tumors became smaller once after each therapy. However, local recurrence (reenlargement of the original tumor) occurred in 1 of 29 (3%) tumors treated with percutaneous acetic acid injection and 11 of 22 (50%) tumors treated with transcatheter arterial embolization (p < 0.005). During the follow-up, 4 of 25 (16%) patients treated with percutaneous acetic acid injection and 10 of 15 (67%) patients treated with transcatheter arterial embolization died. The 1-, 2-, and 3-yr survival rate was 100, 94, and 83%, respectively, in patients treated with percutaneous acetic acid injection and 72, 65, and 39% in patients treated with transcatheter arterial embolization (p < 0.005). The cancer-free survival rate was also significantly better in the former than in the latter group (p < 0.005).

CONCLUSIONS:

Percutaneous acetic acid injection is superior to segmental transcatheter arterial embolization in the treatment of hypervascular small hepatocellular carcinoma.

• Authors: K Ohnishi, H Yoshioka, K Kosaka, K Toshima, J Nishiyama, C Kameda, S Ito, K Fujiwara
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 91 Issue 12 Pg. 2574-9 (Dec 1996) ISSN: 0002-9270 [Print] United States
• PMID: 8946989 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Acetic Acid

Topics

• Acetic Acid (therapeutic use)
• Aged
• Angiography
• Arteries
• Carcinoma, Hepatocellular (blood, diagnostic imaging, drug therapy)
• Embolization, Therapeutic
• Female
• Humans
• Injections
• Liver Neoplasms (blood, diagnostic imaging, drug therapy)
• Male
• Middle Aged
• Prognosis
• Survival Analysis
• Ultrasonography