PURPOSE: To evaluate the efficacy and complications of transportal ethanol injection (TPEI) combined with transcatheter arterial chemoembolization to achieve complete tumor necrosis and prevent intrahepatic metastases in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: In 13 patients with HCC, chemoembolization was performed with injection of a mixture of iodized oil and doxorubicin hydrochloride followed by administration of gelatin sponge; 1-4 weeks later, TPEI was performed with percutaneous transhepatic portography. Ethanol (15-65 mL) was injected in the portal veins around the tumor until occlusion. RESULTS: TPEI was successfully performed in all patients. Two patients subsequently underwent surgery; their tumors were resected completely. Two died of hepatic failure. Seven of the nine other patients showed no recurrence or intrahepatic metastasis during follow-up (7-42 months). Histologic examination, performed in nine patients, showed complete necrosis of tumor and scattered or severe necrosis of surrounding tissues. CONCLUSION: This treatment has a strong anticancerous effect and is expected to be used in treatment of properly selected patients with HCC.
PURPOSE: To evaluate the efficacy and complications of transportal ethanol injection (TPEI) combined with transcatheter arterial chemoembolization to achieve complete tumor necrosis and prevent intrahepatic metastases in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: In 13 patients with HCC, chemoembolization was performed with injection of a mixture of iodized oil and doxorubicin hydrochloride followed by administration of gelatin sponge; 1-4 weeks later, TPEI was performed with percutaneous transhepatic portography. Ethanol (15-65 mL) was injected in the portal veins around the tumor until occlusion. RESULTS: TPEI was successfully performed in all patients. Two patients subsequently underwent surgery; their tumors were resected completely. Two died of hepatic failure. Seven of the nine other patients showed no recurrence or intrahepatic metastasis during follow-up (7-42 months). Histologic examination, performed in nine patients, showed complete necrosis of tumor and scattered or severe necrosis of surrounding tissues. CONCLUSION: This treatment has a strong anticancerous effect and is expected to be used in treatment of properly selected patients with HCC.
Authors: D Azoulay; D Castaing; J Krissat; A Smail; G M Hargreaves; A Lemoine; J F Emile; H Bismuth Journal: Ann Surg Date: 2000-11 Impact factor: 12.969