Kamada K, Kitamoto M, Aikata H, Kawakami Y, Kono H, Imamura M, Nakanishi T, Chayama K.
First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima City, Hiroshima, Japan. kkamada@hiroshima-u.ac.jp
BACKGROUND: We evaluated the long-term efficacy of the combination of transcatheter arterial chemoembolization (TACE) using cisplatin-lipiodol suspension and percutaneous ethanol injection (PEI) for treatment of advanced small hepatocellular carcinoma (HCC).
PATIENTS AND METHODS: Sixty-nine patients with HCC less than 3 cm in diameter and at most three lesions were enrolled in this study. HCC nodules were confirmed to be hypervascular by angiography. Thirty-two patients were treated with a combination of TACE and PEI (TACE/PEI group) and 37 patients with TACE alone (TACE group).
RESULTS: The 5-year survival rates were 50% for the TACE/PEI group and 22% for the TACE group. The TACE/PEI group had a slightly but not significantly better survival than the TACE group. The 5-year survival rates of patients with solitary HCC were 61% for the TACE/PEI group and 24% for the TACE group. Although the two therapeutic groups both had high rates of recurrence, the rates in the TACE/PEI group were significantly lower than those in the TACE group (P <0.05). Severe complications such as intraperitoneal bleeding and segmental hepatic infarction were observed at low incidence, and recovered with supportive treatment.
CONCLUSIONS: The
combination of TACE and PEI appears to prolong survival, compared with TACE
alone. This combination therapy can thus be a valuable form of treatment for
unresectable advanced small HCC.
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