Percutaneous alcoholization of the small hepatocarcinoma

Percutaneous ethanol injection (PEI) under ultrasound guidance is a new therapeutic possibility for patients with small hepatocellular carcinoma (HCC). In our series, 51 patients with a total of 72 lesions were treated (tumor size 0.8-5.0 cm). No significant complications occurred after 745 treatments. Forty patients presented complete remission, as no evidence of residual HCC was revealed during the follow-up (mean 18 months). Ten patients with lesions larger than 3.5 cm and one with lesion less than 3 cm presented partial remission (80-90% of necrosis). The cumulative survival rates at 1, 2 and 3 years (Kaplan-Meier method) were 100%, 89% and 58%. The survival rates for patients carrier of single lesion were 100%, 94% and 71% respectively. In comparison with the survival curves of untreated and surgically treated patients, PEI seems to be the better treatment for operable HCC smaller than 3 cm, and for lesions smaller than 5 cm in patients with surgical risk.