LONG-TERM RESULTS OF PERCUTANEOUS ETHANOL INJECTION THERAPY FOR HEPATOCELLULAR-CARCINOMA IN CIRRHOSIS - A EUROPEAN EXPERIENCE

The objective of our work was to evaluate the long-term results of per cutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in patients with liver cirrhosis. A total of 184 cirrh otic patients with HCC underwent PEI as the only anticancer treatment over an 8-year period. Patients were followed after therapy by means o f clinical examinations, laboratory tests, and US and CT studies perfo rmed at regular time intervals. Survival rates were determined accordi ng to the Kaplan-Meier method. The overall survival was 67 % at 3 year s, 41 % at 5 years, and 19 % at 7 years. The 3-, 5-, and 7-year surviv al rates of patients with single HCC less than or equal to 3 cm (78, 5 4, and 28 %, respectively) were significantly higher (p < 0.01) than t hose of patients with single HCC of 3.1-5 cm (61, 32, and 16, respecti vely) or multiple HCCs (51, 21, and 0 %, respectively). Survival of Ch ild-Pugh A patients (79 % at 3 years, 53 % at 5 years, and 32 % at 7 y ears) was significantly longer (p < 0.01) than that of Child-Pugh B pa tients (50 % at 3 years, 28 % at 5 years, and 8 % at 7 years). A selec ted group of 70 patients with Child-Pugh A cirrhosis and single HCC le ss than or equal to 3 cm had a 7-year survival of 42 %. Long-term surv ival of cirrhotic patients with HCC treated with PEI is comparable to that reported in published series of matched patients submitted to sur gical resection.