TRANSCATHETER ARTERIAL EMBOLIZATION FOLLOWED BY PERCUTANEOUS ETHANOL INJECTION IN THE TREATMENT OF HEPATOCELLULAR-CARCINOMA

Purpose: The aim of this study was to evaluate the effectiveness of tr anscatheter arterial embolization (TAE) followed by percutaneous ethan ol injection (PEI) in the treatment of large hepatocellular carcinoma (HCC) lesions. Methods: Fifteen patients with HCC were treated by mean s of TAE followed by 6-16 ethanol injections. In 10 patients, the HCC was solitary (3-8 cm); 3 patients had 1, and 2 patients had 2 daughter nodules (3 cm or smaller) in addition. In 12 of 15 main tumors and in 4 of 7 daughter nodules, a tumor capsule was observed by computed tom ography or magnetic resonance imaging. Results: Combined treatment wit h TAE and PEI resulted in complete necrosis of 12 of 15 main tumors an d 7 of 7 daughter nodules on biopsy. Treatment failure (incomplete nec rosis) occurred in 3 unencapsulated main tumors. The 1-year survival r ate in 10 patients was 100%. Conclusion: The combination of TAE and PE I proved to be an effective treatment for large HCC, including those w ith 1-2 small daughter nodules. The presence of a tumor capsule signif icantly correlates (p < 0.05) with a favorable outcome of treatment.