|Title:||Percutaneous Ethanol Injection Versus Surgical Resection for the Treatment of Small Hepatocellular Carcinoma: A Prospective Study||Authors:||HUANG, GUAN-TARN
|Issue Date:||2005||Journal Volume:||v.242||Journal Issue:||n.1||Start page/Pages:||36-42||Source:||ANNALS OF SURGERY||Abstract:||
Objective: To compare disease recurrence and survival among patients with small hepatocellular carcinoma after surgical resection or percutaneous ethanol injection therapy, 2 treatments that have not been evaluated with a prospective study. Methods: A total of 76 patients were randomly assigned to 2 groups based on treatment; all had one or 2 tumors with diameter <=3 cm, with hepatitis without cirrhosis or Child class A or B cirrhosis without evident ascites or bleeding tendency. Results: Follow-up ranged from 12 to 59 months. Among percutaneous injection patients, 18 had recurrence 1 to 37 months after treatment (true recurrence, 11; original safety margin inadequate, 3; limitation of imaging technology to detect tiny tumors, 4). Three injection therapy patients died of cancer 25 , 37, and 57 months after treatment. For the surgical resection group, 15 had recurrence 2 to 54 months after treatment (true recurrence, 12; limitation of imaging, 2; neck metastasis, 1 ). Five resection patients died of cancer at 11, 20, 23, 26, and 52 months, respectively. By Cox regression model and Kaplan-Meier survival analysis, there is no statistical significance for recurrence and survival between treatment groups. However, tumor size larger than 2 cm and alpha- fetoprotein over 200 ng/mL correlated with higher recurrence rate, and Child class B liver cirrhosis correlated with shorter survival. Conclusions: Percutaneous ethanol injection therapy appears to be as safe and effective as resection , and both treatments can be considered first-line options for small hepatocellular carcinoma.
|Appears in Collections:||醫學系|
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