Percutaneous hot saline injection therapy: Effectiveness in large hepatocellular carcinoma

PURPOSE: To report on the efficacy of percutaneous hot saline injection the rapy (PSIT) in the treatment of large hepatocellular carcinoma (HCC). MATER IALS AND METHODS: Twenty-nine patients with 31 HCCs underwent PSIT, Physiologic sali ne was mixed with contrast medium and Lipiodol; this mixture was boiled and injected into the tumor. Mean tumor diameter was 7.0 cm. Initial regressio n rates were evaluated at 3-month interval with computed tomography (CT) an d alpha-fetoprotein level measurement. Cumulative survival rates were calcu lated with the Kaplan-Meier method. Multivariate analysis using Cox's propo rtional hazard regression model was performed to determine the significant prognostic factors. RESULTS: Initial regression rate for all tumors at a 3-month interval was 4 2% (13 of 31 tumors) and the median survival was 10.0 months (range, 3.0-36 .0 months). The significant prognostic factors were encapsulated tumors, tu mors less than 10 cm in diameter, tumors with even saline dispersion, tumor s with initial regression at 3-month follow-up, and TNM stage II or III rat her than TV. CONCLUSION: PSIT is a feasible alternative treatment for a large HCC when t ranscatheter arterial chemoembolization is not feasible or has failed.