PURPOSE: The aim of this study was to compare results over time of Transcatheter Arterial Chemo Embolization (TACE), Percutaneous Ethanol Injection (PEI), Laser Thermal Ablation (LTA) and combined therapy of large Hepatocellular Carcinoma (HCC). MATERIALS AND METHODS:Between 1995 and 2003, 89 cirrhosis patients (51 Child-Pugh A, 38 Child-Pugh B) with at least one nodule of HCC =/> 40 mm, were included in this randomized study; 21 were treated with TACE, 20 with PEI, 29 with LTA and 19 with combined therapy. The total number of HCC nodules was 92 with a mean diameter of 52.9 mm. RESULTS: No major complication occurred in all procedures. CT scan showed that complete necrosis was achieved in 83% of treated nodules (76 out of 92); as a whole, the disease relapsed in 18 (20.2%) patients (disease free interval being 18.2+/-9.4 months). The cumulative survival rates were 69.6%, 25.1% and 9.8% at 12, 36 and 60 months respectively. Univariate analysis of survival showed statistically significant differences in the comparison between Child-Pugh A group vs B (p<0.0001) and between single nodule vs multiple (p=0.0019). Patients subjected to combined therapy and LTA showed a statistically significant longer survival than those treated with TACE and PEI. CONCLUSIONS:LTA proves to be the most effective treatment for HCC < 50 mm, combined therapy is the best choice for nodules =/> 50 mm since complete necrosis is achieved in almost all cases and better total survival in the treated patients.
RCT Entities:
PURPOSE: The aim of this study was to compare results over time of Transcatheter Arterial Chemo Embolization (TACE), Percutaneous Ethanol Injection (PEI), Laser Thermal Ablation (LTA) and combined therapy of large Hepatocellular Carcinoma (HCC). MATERIALS AND METHODS: Between 1995 and 2003, 89 cirrhosispatients (51 Child-Pugh A, 38 Child-Pugh B) with at least one nodule of HCC =/> 40 mm, were included in this randomized study; 21 were treated with TACE, 20 with PEI, 29 with LTA and 19 with combined therapy. The total number of HCC nodules was 92 with a mean diameter of 52.9 mm. RESULTS: No major complication occurred in all procedures. CT scan showed that complete necrosis was achieved in 83% of treated nodules (76 out of 92); as a whole, the disease relapsed in 18 (20.2%) patients (disease free interval being 18.2+/-9.4 months). The cumulative survival rates were 69.6%, 25.1% and 9.8% at 12, 36 and 60 months respectively. Univariate analysis of survival showed statistically significant differences in the comparison between Child-Pugh A group vs B (p<0.0001) and between single nodule vs multiple (p=0.0019). Patients subjected to combined therapy and LTA showed a statistically significant longer survival than those treated with TACE and PEI. CONCLUSIONS:LTA proves to be the most effective treatment for HCC < 50 mm, combined therapy is the best choice for nodules =/> 50 mm since complete necrosis is achieved in almost all cases and better total survival in the treated patients.
Authors: Jinhong Jung; Sang Min Yoon; Seungbong Han; Ju Hyun Shim; Kang Mo Kim; Young-Suk Lim; Han Chu Lee; So Yeon Kim; Jin-Hong Park; Jong Hoon Kim Journal: BMC Cancer Date: 2015-12-18 Impact factor: 4.430
Authors: Jinhong Jung; Sang Min Yoon; So Yeon Kim; Byungchul Cho; Jin-hong Park; Su Ssan Kim; Si Yeol Song; Sang-Wook Lee; Seung Do Ahn; Eun Kyung Choi; Jong Hoon Kim Journal: Radiat Oncol Date: 2013-10-27 Impact factor: 3.481