PERCUTANEOUS ETHANOL INJECTION OF HEPATIC-TUMORS - SINGLE-SESSION THERAPY WITH GENERAL-ANESTHESIA

OBJECTIVE. We studied the feasibility and the effectiveness of percuta neous ethanol injection, performed with general anesthesia in a single session, for treating malignant hepatic lesions. SUBJECTS AND METHODS . We treated 30 patients with sonographically guided percutaneous inje ction of ethanol. Twenty had hepatocellular carcinoma and cirrhosis, a nd 10 had hepatic metastases, principally from colon cancer. The mean volume of ethanol injected was 57 ml (range, 6-165 ml). RESULTS. CT sh owed complete necrosis (up to 8.2 cm) in seven of 10 patients with enc apsulated hepatocellular carcinoma and about 90% necrosis in the remai ning three patients. In four of these patients, the alpha-fetoprotein level fell from more than 200 ng/ml to less than 20 ng/ml during treat ment. In 10 patients with infiltrating hepatocellular carcinoma, about 70-90% necrosis was achieved; in six of these patients, the alpha-fet oprotein level, which had been more than 200 ng/ml, decreased during t reatment. In the 10 patients with metastases, more than 50% necrosis w as always achieved. Levels of carcinoembryonic antigen decreased after treatment in all patients. In three patients who had cirrhosis with s uperficial hepatocellular carcinoma, peritoneal hemorrhage occurred bu t did not require transfusion. CONCLUSION. Our results show that percu taneous injection of ethanol in a single session with general anesthes ia is feasible and effective and has several advantages over multisess ion therapy. These include shorter treatment time and the ability to t reat larger and more numerous lesions.