Object:
@EN the surgical resection for hepatocellular carcinoma (HCC) with posnecrotic cirrhosis has been restricted due to poor postoperative functional reserve, the development of new lesion in remained liver and patient's refusal against operation.
The
aim
of this study was to assess the effect of percutanous ethanol injection therapy (PEIT) for the patients with small HCC in whom surgical resection was restricted.
@ES Material and Method:
@EN The subjects of this study were ten patients who were confirmed as small HCC by ultrasound guided liver biopsy. The mean age of the patients was 53.9±7.5 years, the male to female ratio was 9 to 1.HBs Ag was noted in eight cases, Anti-HBs
antibody
was noted in one case, and only Anti-HBc IgG positive was noted in one cases among 10 cases. five cases were assessed as Child A, four cases were Child B, and one cases was Child C. In AFP level, lesser than 350ng/ml was checked in four cases and
more
than 350ng/ml was checked in six cases. the average size of tumor was 3.1±0.8cm. Under the guidance of ultrasonography, we punctured the mass with 21-22 guage needle and then injected optimal amounts of the mixture of 99.5% ethanol and 2%
lidocaine
(ratio of 9:1) until the echogeneisity of tumor was completely changed from hypoechoic to hyperechoic (if need, maximum, 3 puncture were done) as one time. Above procedure was performed 3-6 times repeatedly every 2-3 days as one cycel. We
followed
up
the tumor by abdominal ultrasonography and serum AFP after one month and then every three months. If the regrowth of the tumor was detected or if the development of new lesion was suspected, color Doppler ultrasound, abdominal computed tomography
or
hepatic angiography was performed. And then we performed the second cycle of PEIT or TAE for the regrowing or new lesion.
@ES Results:
@EN After the first cycle of PEIT the mean of survival duration was 18.4±10.6 months, one year survival rate was 70% and two years survival rate was 30%. The average duration of survival was 21.4 months in Child A, 13.2 months in Child B, and
the
maximal duration of survival was more than five years at now.
@ES Conclusion:
@EN The PEIT was considered relatively safe and effective method for inoperablesmall HCC, but one cycle therapy was not sufficient. We suggest that it is necessary to detect the relapse or regrowing of tumor early by careful observation after
PEIT
and
to perform the combination of second PEIT or TAE.
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