Therapeutic Efficacy and Safety of Percutaneous Ethanol Injection with or without Combined Radiofrequency Ablation for Hepatocellular Carcinomas in High Risk Locations.
10.3348/kjr.2013.14.2.240
- Author:
Dong Ik CHA
1
;
Min Woo LEE
;
Hyunchul RHIM
;
Dongil CHOI
;
Young Sun KIM
;
Hyo K LIM
Author Information
1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. leeminwoo0@gmail.com
- Publication Type:Original Article
- Keywords:
Radiofrequency ablation;
Percutaneous ethanol injection;
Hepatocellular carcinoma;
Liver imaging;
Complication
- MeSH:
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
- From:Korean Journal of Radiology
2013;14(2):240-247
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: 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.
