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Therapeutic efficacy and safety of percutaneous ethanol injection with or without combined radiofrequency ablation for hepatocellular carcinomas in high risk locations.

AbstractOBJECTIVE:
To evaluate the therapeutic efficacy and safety of percutaneous ethanol injection (PEI) alone and combined with radiofrequency ablation (RFA) for hepatocellular carcinomas (HCCs) in high risk locations.
MATERIALS AND METHODS:
We performed PEI for HCCs in RFA-high risk locations, either alone or in combination with RFA. There were 20 HCCs (1.7 ± 0.9 cm) in 20 patients (PEI group: n = 12; PEI + RFA group: n = 8). We evaluated technical success, local tumor progression and complications in both groups.
RESULTS:
Technical success was achieved in all HCCs in both groups. During follow-up, local tumor progression was found in 41.7% (5/12) in the PEI group, whereas 12.5% (1/8) for the PEI + RFA group (p = 0.32). Bile duct dilatation was the most common complication, especially when the tumors were in periportal locations; 55% (5/9) in the PEI group and 50% (2/4) in the PEI + RFA group (p = 1.00). One patient in the PEI group developed severe biliary stricture and upstream dilatation that resulted in atrophy of the left hepatic lobe. One patient treated with PEI + RFA developed cholangitis and an abscess.
CONCLUSION:
Combined PEI and RFA treatment has a tendency to be more effective than PEI alone for managing HCCs in high risk locations, although the difference is not statistically significant. Even though PEI is generally accepted as a safe procedure, it may cause major biliary complications for managing HCCs adjacent to the portal vein.
AuthorsDong Ik Cha, Min Woo Lee, Hyunchul Rhim, Dongil Choi, Young-sun Kim, Hyo K Lim
JournalKorean journal of radiology (Korean J Radiol) 2013 Mar-Apr Vol. 14 Issue 2 Pg. 240-7 ISSN: 2005-8330 [Electronic] Korea (South)
PMID23483664 (Publication Type: Journal Article)
Chemical References
  • Ethanol
Topics
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular (drug therapy, surgery)
  • Catheter Ablation (methods)
  • Chemoembolization, Therapeutic (methods)
  • Disease Progression
  • Ethanol (administration & dosage)
  • Female
  • Humans
  • Liver Neoplasms (drug therapy, surgery)
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed

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