COMBINED TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION AND PERCUTANEOUS ETHANOL INJECTION FOR THE TREATMENT OF LARGE HEPATOCELLULAR-CARCINOMA - LOCAL THERAPEUTIC EFFECT AND LONG-TERM SURVIVAL RATE

The aim of our study was to investigate local therapeutic effects and long-term results of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of l arge hepatocellular carcinoma (HCC). Eight-six patients (67 males and 19 females, age range 48-75 years, mean age 65.1 years) with Child-Pug h class A (n = 48) or B (n = 38) liver cirrhosis and a large HCC (main tumor 3.1-8 cm in diameter with no more than two daughter nodules) we re enrolled in a prospective study. All patients underwent a single TA CE session followed by PEI. Follow-up ranged from 4 to 64 months (mean 27.8 months, median 26 months). No major complication occurred. The l ocal therapeutic effect, as assessed on the basis of findings at CT an d MR imaging, was complete response in 71 of 86 patients (82%) and par tial response in 15 of 86. Overall survival rates by the Kaplan-Meier method were 92% at 1 year, 83% at 2 years, 69% at 3 years, 58% at 4 ye ars, and 47% at 5 years. Survival of Child-Pugh A patients (75% at 3 y ears and 59% at 5 years) was significantly longer (p < 0.01) than that of Child-Pugh B patients (61% at 3 years and 35% at 5 years). Combine d TACE and PEI is an effective treatment for large HCC.