Treatment of hepatocellular carcinoma associated with cirrhosis by ultrasonograhic guided percutaneous ethanol injection

ABSTRACT

This study aimed to evaluate the short-term response to ultrasonographic guided percutaneous ethanol injection [PEI] for hepatocellular carcinoma [HCC] in cirrhotic patients. The study included 20 cirrhotic patients with HHC. Cases with severe liver impairment [Child's class C], severe bleeding tendency, impaired prothrombin concentration, thrombocytopenia, big tumors [more than 5 cm] or more than one tumor were excluded from the study. The patients were treated with percutaneous injection of ethanol 95% under guidance with ultrasound. The total amount of injected ethanol per session was between 5-20 ml. One to nine administrations were performed for each lesion according to its size. No serious complications occurred during or after treatment. The patients were followed up for 9-12 months. All lesions had post treatment sonographic structured changes of fibronecrotic echopattern. All patients were followed up by aspiration cytology at the end of treatment and at three and six months and yielded negative results for malignancy in all cases, except one who responded adequately to re-injection, with a significant reduction in the tumor size. Alpha fetoprotein level dropped significantly. No biochemical changes or untoward clinical sequelae were detected