Trattamento combinato dell'epatocarcinoma con chemioembolizzazione e alcoolizzazione. Risultati a lungo termine

Translated title of the contribution: Treatment of hepatocellular carcinoma with combined transcatheter arterial chemoembolization and percutaneous ethanol injection: Long-term results

Carlo Bartolozzi, Riccardo Lencioni, Nicola Armillotta

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

We investigated the long-term outcome of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC). A series of 86 patients with biopsy-proved HCC were treated at our Institution January, 1991, to June, 1996. All patients had a single primary tumor bigger than 3 cm, occurring solitary or associated with no more than 2 daughter nodules. Forty-eight patients were in Child class A and 38 patients were in Child class B. The diameter of the lesions ranged 3 to 8 am (mean: 5.3 cm). The treatment schedule included a single TACE performed via a segmental approach by injecting an emulsion of 20-70 mg adriblastin or farmorubicin and 5-20 ml Lipiodol followed by gelatin sponge particles. Four weeks later, CT and MR follow-up studies were performed and PEI was subsequently started. PEI included 4-16 treatment sessions (mean: 6.8 sessions) performed under US guidance. The total amount of alcohol administered ranged 16 to 215 ml (mean: 69 ml). All patients were followed after therapy with clinical examinations, laboratory tests, and US, CT, and MR studies performed at regular time intervals. The follow-up period ranged 4 to 65 months (mean: 27.8 months; median: 26 months). No major treatment-related complication occurred. The therapeutic response, as assessed with imaging studies performed after the end of treatment, was complete tumor necrosis in 71 of 86 patients (82%) and partial tumor necrosis in the remaining 15. Overall survival rates by the Kaplan-Meier method were 92% at 1 year, 83% at 2 years, 69% at 3 years, 58% at 4 years, and 47% at 5 years. The survival of Child A patients (75% at 3 years and 59% at 5 years) was significantly longer (p < .01) than that of Child B patients (61% at 3 years and 35% at 5 years). During the follow-up, a recurrence of the treated tumors was observed in 5 patients, and new HCCs appeared in 46 patients. The 1-, 2-, 3-, 4-, and 5-year recurrence fates by the KaplanMeier method were 14%, 35%, 56%, 69%, and 82%, respectively. The long-term results of combined treatment with TACE and PEI confirm the effectiveness of this therapeutic approach in patients with large uninodular HCC.

Translated title of the contributionTreatment of hepatocellular carcinoma with combined transcatheter arterial chemoembolization and percutaneous ethanol injection: Long-term results
Original languageItalian
Pages (from-to)19-23
Number of pages5
JournalRadiologia Medica
Volume94
Issue number1-2
StatePublished - Jul 1 1997

Keywords

  • HCC, interventional radiology
  • HCC, therapy
  • Liver neoplasms, therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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