Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis

Percutanous ethanol injection (PEI) is performed under ultrasound guidance, with multiple sessions, either on an out-patient basis or using a 'single session' technique under general anaesthesia, depending on the size and num ber of lesions. In our experience with Child's A (293), B (149), or C (20) class patients with cirrhosis and a single hepatocellular carcinoma (HCC) l ess than or equal to 5 cm, the 1, 3 and 5 year survival rates were 98-79-47 %, 93-63-29%, and 64-12-0%, respectively. In our 108 patients with larger H CC, 1-3 year survival rates were: 72-57% in single, encapsulated tumours; 7 3-42% in single infiltrating, or multiple encapsulated tumours; and 46-0% i n symptomatic cases, or in tumours with advanced portal thrombosis. PEI pro ved to be a safe, effective, repeatable, simple and low-cost therapy for HC C. Survival after PEI was comparable to that after surgical resection, prob ably due to a balancing between the greater complete ablation rate of surge ry versus the absence of early mortality and liver damage of PEI.