Radiology, Vol 185, 457-460, Copyright © 1992 by Radiological Society of North America

ARTICLES

Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization

K Tanaka, S Nakamura, K Numata, H Okazaki, O Endo, S Inoue, Y Takamura, M Sugiyama and Y Ohaki
Third Department of Internal Medicine, Yokohama City University School of Medicine, Japan.

The therapeutic effectiveness of a new combination therapy-- pretreatment with transcatheter arterial embolization (TAE) and subsequent percutaneous ethanol injection (PEI)--for solitary large (> 3.0 cm in diameter) primary hepatocellular carcinoma lesions was compared with that of TAE alone. With TAE alone, a partial response of the tumor was seen in only 10% of the patients, and the 1-, 2-, and 3- year survival rates were calculated to be 68%, 37%, and 0%, respectively. Histologic examination of specimens obtained at hepatectomy showed that TAE alone caused complete necrosis in only 20% of the tumors. In contrast, PEI combined with TAE significantly (P < .05) increased the partial response rate (45%) and significantly (P < .01) prolonged the 1-, 2-, and 3-year survival rates (100%, 85%, and 85%, respectively). Combination therapy caused complete histologic necrosis in 83% of the tumors. It also was significantly (P < .05) better than TAE alone in terms of rate of primary tumor recurrence during follow-up.

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