Brief Article
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World J Gastroenterol. Jul 14, 2011; 17(26): 3126-3132
Published online Jul 14, 2011. doi: 10.3748/wjg.v17.i26.3126
Ethanol injection is highly effective for hepatocellular carcinoma smaller than 2 cm
Maurizio Pompili, Erica Nicolardi, Valeria Abbate, Luca Miele, Laura Riccardi, Marcello Covino, Nicoletta De Matthaeis, Antonio Grieco, Raffaele Landolfi, Gian Ludovico Rapaccini
Maurizio Pompili, Erica Nicolardi, Valeria Abbate, Luca Miele, Laura Riccardi, Nicoletta De Matthaeis, Antonio Grieco, Raffaele Landolfi, Gian Ludovico Rapaccini, Department of Internal Medicine, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
Marcello Covino, Department of Emergency, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
Author contributions: Pompili M and Rapaccini GL designed the research; Nicolardi E, Abbate V, Riccardi L and De Matthaeis N performed the research; Covino M and Miele L analyzed the data; Pompili M, Nicolardi E, Grieco A and Landolfi R wrote the paper.
Correspondence to: Maurizio Pompili, MD, Professor of Medicine, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Roma, Italy. mpompili@rm.unicatt.it
Telephone: +39-6-30155161 Fax: +39-6-35502775
Received: December 30, 2010
Revised: March 5, 2011
Accepted: March 12, 2011
Published online: July 14, 2011
Abstract

AIM: To analyze the long-term prognosis in a cohort of western cirrhotic patients with single hepatocellular carcinoma treated with ethanol injection.

METHODS: One-hundred forty-eight patients with solitary hepatocellular carcinoma were enrolled. The tumor diameter was lower than 2 cm in 47 patients but larger in the remaining 101 patients. The impact of some pre-treatment clinical and laboratory parameters and of tumor recurrence on patients’ survival was assessed.

RESULTS: Among the pre-treatment parameters, only a tumor diameter of less than 2 cm was an independent prognostic factor of survival. The occurrence of new nodules in other liver segments and the neoplastic portal invasion were linked to a poorer prognosis at univariate analysis. Patients with a single hepatocellular carcinoma smaller than 2 cm showed a better 5-year cumulative survival (73.0% vs 47.9%) (P = 0.009), 3-year local recurrence rate (29.1% vs 51.5%) (P = 0.011), and 5-year distant intrahepatic recurrence rate (52.9% vs 62.8%) (P = 0.054) compared to patients with a larger tumor.

CONCLUSION: The 5-year survival rate of patients with single hepatocellular carcinoma < 2 cm undergoing ethanol injection is excellent and comparable to that achieved using radiofrequency ablation.

Keywords: Hepatocellular carcinoma, Cirrhosis, Percutaneous ethanol injection, Prognosis