NEEDLE TRACT IMPLANTATION OF HEPATOCELLULAR-CARCINOMA AFTER PERCUTANEOUS ETHANOL INJECTION

BACKGROUND. Percutaneous ethanol injection (PEI) therapy currently is widely used for small hepatocellular carcinoma (HCC). However, only li mited information is available regarding needle tract implantation aft er PEI treatment. METHODS. Records of HCC patients who underwent PEI b etween March 1990 and April 1997 at the National Cancer Center Hospita l (n = 177) were reviewed to clarify the incidence, risk factors, and outcome of needle tract implantation of HCC. RESULTS. PEI was performe d for 348 HCC patients with a median tumor size of 20 mm. Needle tract implantation was found in 4 patients (10, 13, 15, and 46 months, resp ectively, after PEI). The size of the PEI-treated HCC tumors in these patients was 20, 27, 28, and 30 mm, respectively, in greatest dimensio n. All tumors were enhanced in the early phase on dynamic computed tom ography (CT), and were found to have moderate tumor cell differentiati on on biopsied specimens. Of the four implanted tumors, three were res ected and the remaining tumor was treated with extrabeam radiotherapy. At last follow-up, 2 of the 4 patients had died (1 of variceal bleedi ng 60 months after PEI and the other from cancer 61 months after PEI) and 2 were still alive (14 and 20 months, respectively, after PEI) wit h no evidence of active tumor. CONCLUSIONS. Needle tract implantation after PEI is not unusual, especially when HCC tumors are greater than or equal to 2 cm in greatest dimension, enhanced in the early phase on dynamic CT, and/or moderately differentiated on biopsied specimens. ( C) 1998 American Cancer Society.