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Radiology, Vol 197, 101-108, Copyright © 1995 by Radiological Society of North America

ARTICLES

Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection

T Livraghi, A Giorgio, G Marin, A Salmi, I de Sio, L Bolondi, M Pompili, F Brunello, S Lazzaroni and G Torzilli
Department of Radiology, Ospedale Civile, Vimercate, Milan, Italy.

PURPOSE: To define indications for percutaneous ethanol injection (PEI) in patients with hepatocellular carcinoma (HCC) and cirrhosis. MATERIALS AND METHODS: Survival rates were determined in 746 patients who had undergone PEI (567 men, 179 women; mean age, 64.3 years; mean follow-up, 36 months). RESULTS: In patients with Child A (n = 293), B (n = 149), or C (n = 20) cirrhosis and single HCCs 5 cm or smaller, the 3-5 year survival rate was 47%-79%, 29%-63%, and 0%-12%, respectively. In patients with Child A cirrhosis, it was 36%-68% for multiple HCCs (n = 121), 30%-53% for single HCCs larger than 5 cm (n = 28), and 0%-16% for advanced HCC (n = 16). Treatment was associated with a 1.7% rate of severe complications and a 0.1% mortality rate. CONCLUSION: PEI proved safe, effective, and repeatable and had a low cost. Survival after PEI was comparable to that after surgery, probably because of a balancing between greater radicality of surgery and absence of early mortality and liver damage of PEI.


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